- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.67 / $76.42 / $135.12
| Facility | | $28.67 | $76.42 | $135.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.52 / $11.60 / $12.88
| Professional | | $9.52 | $11.60 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.01 / $11.32 / $35.47
| Facility | | $11.01 | $11.32 | $35.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.10 / $14.87 / $18.59
| Professional | | $8.10 | $14.87 | $18.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $14.81 / $57.96
| Facility | | $12.88 | $14.81 | $57.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.86 / $10.58 / $14.76
| Professional | | $9.86 | $10.58 | $14.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.41 / $7.61 / $7.73
| Professional | | $5.41 | $7.61 | $7.73 |