- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.09 / $38.61 / $91.37
| Facility | | $21.09 | $38.61 | $91.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.03 / $13.03 / $13.42
| Professional | | $13.03 | $13.03 | $13.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.54 / $18.72 / $26.13
| Facility | | $17.54 | $18.72 | $26.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.34 / $11.92 / $24.54
| Professional | | $8.34 | $11.92 | $24.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.01 / $30.76 / $54.07
| Facility | | $12.01 | $30.76 | $54.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.31 / $14.25 / $22.72
| Professional | | $9.31 | $14.25 | $22.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $9.41 / $25.42
| Professional | | $5.25 | $9.41 | $25.42 |