- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.78 / $68.06 / $118.69
| Facility | | $38.78 | $68.06 | $118.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.89 / $4.61 / $6.39
| Professional | | $3.89 | $4.61 | $6.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.83 / $10.44 / $11.72
| Professional | | $7.83 | $10.44 | $11.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $5.84 / $7.34
| Professional | | $5.78 | $5.84 | $7.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.37 / $48.72 / $107.35
| Facility | | $5.37 | $48.72 | $107.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $3.62 / $10.36
| Professional | | $2.59 | $3.62 | $10.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $5.70 / $8.88
| Professional | | $2.18 | $5.70 | $8.88 |