- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.53 / $30.42 / $99.70
| Facility | | $12.53 | $30.42 | $99.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.06 / $11.61 / $17.86
| Professional | | $10.06 | $11.61 | $17.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.01 / $16.62 / $45.01
| Facility | | $13.01 | $16.62 | $45.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.42 / $6.42 / $13.46
| Professional | | $6.42 | $6.42 | $13.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.11 / $21.78 / $43.57
| Facility | | $9.11 | $21.78 | $43.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $14.87 / $19.07
| Professional | | $8.32 | $14.87 | $19.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.46 / $7.81 / $18.17
| Professional | | $5.46 | $7.81 | $18.17 |