- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.56 / $37.64 / $234.60
| Facility | | $20.56 | $37.64 | $234.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $10.79 / $13.08
| Professional | | $10.30 | $10.79 | $13.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.79 / $15.45 / $25.48
| Facility | | $14.79 | $15.45 | $25.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.59 / $9.42 / $23.92
| Professional | | $6.59 | $9.42 | $23.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.76 / $29.98 / $52.71
| Facility | | $11.76 | $29.98 | $52.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.13 / $13.89 / $18.07
| Professional | | $9.13 | $13.89 | $18.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $8.77 / $20.10
| Professional | | $5.25 | $8.77 | $20.10 |