- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.50 / $47.12 / $118.75
| Facility | | $12.50 | $47.12 | $118.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $10.02 / $13.46
| Professional | | $8.32 | $10.02 | $13.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.26 / $14.39 / $38.96
| Facility | | $11.26 | $14.39 | $38.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.46 / $5.56 / $12.59
| Professional | | $5.46 | $5.56 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.86 / $18.85 / $36.94
| Facility | | $7.86 | $18.85 | $36.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $13.22 / $16.78
| Professional | | $7.15 | $13.22 | $16.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.26 / $11.26 / $11.26
| Facility | | $11.26 | $11.26 | $11.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.73 / $6.76 / $15.73
| Professional | | $4.73 | $6.76 | $15.73 |