- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.46 / $89.64 / $129.06
| Facility | | $57.46 | $89.64 | $129.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.34 / $9.56 / $16.91
| Professional | | $3.34 | $9.56 | $16.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.22 / $61.75 / $62.21
| Professional | | $52.22 | $61.75 | $62.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.15 / $11.26 / $14.16
| Professional | | $11.15 | $11.26 | $14.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.06 / $62.57 / $113.40
| Facility | | $9.06 | $62.57 | $113.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.68 / $6.23 / $19.54
| Professional | | $2.68 | $6.23 | $19.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.68 / $4.88 / $14.17
| Professional | | $2.68 | $4.88 | $14.17 |