- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.42 / $33.72 / $164.06
| Facility | | $18.42 | $33.72 | $164.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $10.02 / $11.26
| Professional | | $8.32 | $10.02 | $11.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.26 / $13.85 / $22.82
| Facility | | $13.26 | $13.85 | $22.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.44 / $8.44 / $21.42
| Professional | | $8.44 | $8.44 | $21.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.51 / $26.88 / $47.25
| Facility | | $10.51 | $26.88 | $47.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.05 / $12.44 / $16.52
| Professional | | $8.05 | $12.44 | $16.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.94 / $10.50 / $18.02
| Professional | | $3.94 | $10.50 | $18.02 |