- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.32 / $111.72 / $146.47
| Facility | | $21.32 | $111.72 | $146.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.46 / $14.31 / $21.32
| Professional | | $12.46 | $14.31 | $21.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.40 / $14.81 / $46.42
| Facility | | $14.40 | $14.81 | $46.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $19.41 / $24.26
| Professional | | $10.60 | $19.41 | $24.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.84 / $19.37 / $75.78
| Facility | | $16.84 | $19.37 | $75.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.89 / $13.84 / $19.55
| Professional | | $12.89 | $13.84 | $19.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.07 / $9.94 / $10.10
| Professional | | $7.07 | $9.94 | $10.10 |