- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.58 / $128.46 / $313.08
| Facility | | $36.58 | $128.46 | $313.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.19 / $19.47 / $22.34
| Professional | | $19.19 | $19.47 | $22.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.31 / $27.48 / $45.32
| Facility | | $26.31 | $27.48 | $45.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.73 / $16.76 / $42.52
| Professional | | $11.73 | $16.76 | $42.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.53 / $53.33 / $93.74
| Facility | | $34.53 | $53.33 | $93.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.18 / $24.70 / $32.01
| Professional | | $17.18 | $24.70 | $32.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.82 / $28.19 / $36.39
| Professional | | $7.82 | $28.19 | $36.39 |