- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.97 / $31.06 / $230.98
| Facility | | $16.97 | $31.06 | $230.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.80 / $32.94 / $32.94
| Professional | | $10.80 | $32.94 | $32.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.10 / $47.31 / $49.41
| Facility | | $14.10 | $47.31 | $49.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.73 / $30.13 / $30.13
| Professional | | $19.73 | $30.13 | $30.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.76 / $24.74 / $106.62
| Facility | | $9.76 | $24.74 | $106.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.52 / $11.46 / $57.82
| Professional | | $7.52 | $11.46 | $57.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.57 / $17.85 / $52.83
| Professional | | $7.57 | $17.85 | $52.83 |