- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.52 / $124.35 / $545.87
| Facility | | $53.52 | $124.35 | $545.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.23 / $17.91 / $20.98
| Professional | | $17.23 | $17.91 | $20.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.14 / $20.72 / $64.94
| Facility | | $20.14 | $20.72 | $64.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.47 / $27.26 / $34.07
| Professional | | $12.47 | $27.26 | $34.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.57 / $27.11 / $95.46
| Facility | | $23.57 | $27.11 | $95.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.05 / $19.26 / $27.13
| Professional | | $18.05 | $19.26 | $27.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.90 / $11.70 / $14.14
| Professional | | $9.90 | $11.70 | $14.14 |