- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.68 / $78.12 / $366.61
| Facility | | $42.68 | $78.12 | $366.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.72 / $23.23 / $23.64
| Professional | | $22.72 | $23.23 | $23.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.71 / $32.07 / $52.87
| Facility | | $30.71 | $32.07 | $52.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.69 / $19.55 / $49.63
| Professional | | $13.69 | $19.55 | $49.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.52 / $62.21 / $109.37
| Facility | | $24.52 | $62.21 | $109.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.79 / $28.82 / $37.69
| Professional | | $18.79 | $28.82 | $37.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.95 / $21.85 / $51.58
| Professional | | $10.95 | $21.85 | $51.58 |