- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.50 / $148.50 / $218.73
| Facility | | $52.50 | $148.50 | $218.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.55 / $8.49 / $11.08
| Professional | | $7.55 | $8.49 | $11.08 |
- 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 / $5.40 / $5.66
| Professional | | $3.96 | $5.40 | $5.66 |