- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.36 / $44.65 / $71.17
| Facility | | $10.36 | $44.65 | $71.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.51 / $12.84 / $15.20
| Professional | | $9.51 | $12.84 | $15.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.32 / $12.67 / $39.72
| Facility | | $12.32 | $12.67 | $39.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.03 / $16.93 / $21.17
| Professional | | $9.03 | $16.93 | $21.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.41 / $16.57 / $64.84
| Facility | | $14.41 | $16.57 | $64.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $11.67 / $16.76
| Professional | | $11.03 | $11.67 | $16.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.05 / $6.05 / $8.65
| Professional | | $6.05 | $6.05 | $8.65 |