- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.46 / $113.01 / $333.34
| Facility | | $26.46 | $113.01 | $333.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.41 / $63.92 / $143.82
| Professional | | $15.41 | $63.92 | $143.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.32 / $15.76 / $49.38
| Facility | | $15.32 | $15.76 | $49.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $20.65 / $25.81
| Professional | | $11.22 | $20.65 | $25.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.93 / $20.62 / $80.72
| Facility | | $17.93 | $20.62 | $80.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.73 / $14.65 / $20.75
| Professional | | $13.73 | $14.65 | $20.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.53 / $7.53 / $10.76
| Professional | | $7.53 | $7.53 | $10.76 |