- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.41 / $37.36 / $71.65
| Facility | | $20.41 | $37.36 | $71.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.22 / $10.22 / $12.98
| Professional | | $10.22 | $10.22 | $12.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.68 / $15.33 / $25.28
| Facility | | $14.68 | $15.33 | $25.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.55 / $9.35 / $23.72
| Professional | | $6.55 | $9.35 | $23.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.76 / $29.74 / $52.28
| Facility | | $11.76 | $29.74 | $52.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $13.78 / $18.07
| Professional | | $8.94 | $13.78 | $18.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.36 / $12.60 / $19.94
| Professional | | $4.36 | $12.60 | $19.94 |