- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.74 / $91.48 / $200.57
| Facility | | $25.74 | $91.48 | $200.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.77 / $14.21 / $14.43
| Professional | | $11.77 | $14.21 | $14.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.73 / $19.57 / $31.89
| Facility | | $18.73 | $19.57 | $31.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.35 / $11.93 / $30.27
| Professional | | $8.35 | $11.93 | $30.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.01 / $37.96 / $66.73
| Facility | | $15.01 | $37.96 | $66.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.45 / $16.38 / $22.72
| Professional | | $11.45 | $16.38 | $22.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.57 / $15.75 / $25.46
| Professional | | $5.57 | $15.75 | $25.46 |