- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.82 / $61.20 / $166.85
| Facility | | $17.82 | $61.20 | $166.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.77 / $14.85 / $30.34
| Professional | | $12.77 | $14.85 | $30.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.03 / $21.76 / $58.92
| Facility | | $17.03 | $21.76 | $58.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.23 / $8.41 / $16.52
| Professional | | $8.23 | $8.41 | $16.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.94 / $27.68 / $57.04
| Facility | | $11.94 | $27.68 | $57.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $19.82 / $25.18
| Professional | | $11.03 | $19.82 | $25.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.81 / $17.03 / $21.42
| Facility | | $12.81 | $17.03 | $21.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $10.22 / $25.86
| Professional | | $7.15 | $10.22 | $25.86 |