- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.62 / $81.40 / $375.57
| Facility | | $20.62 | $81.40 | $375.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.65 / $76.25 / $143.82
| Professional | | $15.65 | $76.25 | $143.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.97 / $8.97 / $12.46
| Professional | | $8.97 | $8.97 | $12.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.88 / $16.84 / $22.66
| Facility | | $13.88 | $16.84 | $22.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.46 / $13.12 / $18.30
| Professional | | $12.46 | $13.12 | $18.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.03 / $18.87 / $56.48
| Facility | | $14.03 | $18.87 | $56.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.39 / $13.79 / $25.81
| Professional | | $9.39 | $13.79 | $25.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.53 / $10.53 / $25.06
| Professional | | $7.53 | $10.53 | $25.06 |