- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.93 / $41.98 / $80.50
| Facility | | $22.93 | $41.98 | $80.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $12.21 / $14.59
| Professional | | $11.48 | $12.21 | $14.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.48 / $17.22 / $19.05
| Facility | | $16.48 | $17.22 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.35 / $10.50 / $26.65
| Professional | | $7.35 | $10.50 | $26.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.01 / $33.44 / $58.78
| Facility | | $13.01 | $33.44 | $58.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.19 / $11.03 / $20.13
| Professional | | $10.19 | $11.03 | $20.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.88 / $18.41 / $26.25
| Professional | | $5.88 | $18.41 | $26.25 |