- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.57 / $43.14 / $89.37
| Facility | | $23.57 | $43.14 | $89.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.35 / $11.80 / $25.61
| Professional | | $9.35 | $11.80 | $25.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.95 / $17.70 / $29.20
| Facility | | $16.95 | $17.70 | $29.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.55 / $10.79 / $27.40
| Professional | | $7.55 | $10.79 | $27.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.51 / $34.35 / $60.38
| Facility | | $13.51 | $34.35 | $60.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.38 / $15.91 / $20.65
| Professional | | $10.38 | $15.91 | $20.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $10.51 / $23.02
| Professional | | $5.25 | $10.51 | $23.02 |