- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.36 / $77.02 / $176.41
| Facility | | $21.36 | $77.02 | $176.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.70 / $11.65 / $12.40
| Professional | | $10.70 | $11.65 | $12.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.37 / $16.05 / $26.46
| Facility | | $15.37 | $16.05 | $26.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.85 / $9.78 / $24.85
| Professional | | $6.85 | $9.78 | $24.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.26 / $31.16 / $54.78
| Facility | | $12.26 | $31.16 | $54.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.48 / $14.42 / $18.59
| Professional | | $9.48 | $14.42 | $18.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $9.52 / $20.88
| Professional | | $4.57 | $9.52 | $20.88 |