- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.36 / $54.29 / $71.17
| Facility | | $10.36 | $54.29 | $71.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.36 / $12.24 / $17.60
| Professional | | $10.36 | $12.24 | $17.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.08 / $13.46 / $42.18
| Facility | | $13.08 | $13.46 | $42.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.66 / $17.35 / $21.68
| Professional | | $9.66 | $17.35 | $21.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.30 / $17.60 / $68.84
| Facility | | $15.30 | $17.60 | $68.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.71 / $12.48 / $17.55
| Professional | | $11.71 | $12.48 | $17.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.43 / $9.10 / $9.18
| Professional | | $6.43 | $9.10 | $9.18 |