- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.36 / $54.39 / $94.78
| Facility | | $10.36 | $54.39 | $94.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.36 / $12.55 / $18.27
| Professional | | $10.36 | $12.55 | $18.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.58 / $13.97 / $43.79
| Facility | | $13.58 | $13.97 | $43.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.10 / $18.17 / $22.72
| Professional | | $8.10 | $18.17 | $22.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.89 / $18.27 / $64.34
| Facility | | $15.89 | $18.27 | $64.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.16 / $13.02 / $18.35
| Professional | | $12.16 | $13.02 | $18.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.67 / $7.62 / $9.52
| Professional | | $6.67 | $7.62 | $9.52 |