- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.86 / $127.23 / $198.90
| Facility | | $30.86 | $127.23 | $198.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.46 / $8.23 / $10.38
| Professional | | $7.46 | $8.23 | $10.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.07 / $8.30 / $26.03
| Facility | | $8.07 | $8.30 | $26.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.92 / $10.74 / $13.42
| Professional | | $5.92 | $10.74 | $13.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.44 / $10.86 / $42.48
| Facility | | $9.44 | $10.86 | $42.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.23 / $7.60 / $10.77
| Professional | | $7.23 | $7.60 | $10.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.96 / $5.58 / $5.66
| Professional | | $3.96 | $5.58 | $5.66 |