- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.27 / $40.54 / $289.01
| Facility | | $20.27 | $40.54 | $289.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.73 / $11.23 / $22.46
| Professional | | $10.73 | $11.23 | $22.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.59 / $15.24 / $25.12
| Facility | | $14.59 | $15.24 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.28 / $9.28 / $16.64
| Professional | | $9.28 | $9.28 | $16.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.51 / $29.55 / $51.95
| Facility | | $11.51 | $29.55 | $51.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $10.29 / $17.55
| Professional | | $8.94 | $10.29 | $17.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.20 / $9.05 / $24.50
| Professional | | $5.20 | $9.05 | $24.50 |