- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.36 / $71.17 / $203.37
| Facility | | $10.36 | $71.17 | $203.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.01 / $12.68 / $32.13
| Professional | | $9.01 | $12.68 | $32.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.27 / $10.56 / $33.11
| Facility | | $10.27 | $10.56 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.48 / $13.63 / $17.04
| Professional | | $7.48 | $13.63 | $17.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.01 / $13.81 / $54.03
| Facility | | $12.01 | $13.81 | $54.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.19 / $9.76 / $13.96
| Professional | | $9.19 | $9.76 | $13.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.04 / $5.04 / $7.21
| Professional | | $5.04 | $5.04 | $7.21 |