- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.81 / $79.59 / $96.62
| Facility | | $36.81 | $79.59 | $96.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.31 / $11.98 / $14.56
| Professional | | $10.31 | $11.98 | $14.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.74 / $12.08 / $37.85
| Facility | | $11.74 | $12.08 | $37.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.57 / $15.69 / $19.62
| Professional | | $8.57 | $15.69 | $19.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.74 / $15.80 / $61.84
| Facility | | $13.74 | $15.80 | $61.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.52 / $11.12 / $15.96
| Professional | | $10.52 | $11.12 | $15.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.77 / $8.11 / $8.24
| Professional | | $5.77 | $8.11 | $8.24 |