- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.39 / $96.55 / $261.64
| Facility | | $18.39 | $96.55 | $261.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.47 / $17.05 / $34.08
| Professional | | $14.47 | $17.05 | $34.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.71 / $17.19 / $53.88
| Facility | | $16.71 | $17.19 | $53.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.31 / $22.30 / $27.88
| Professional | | $12.31 | $22.30 | $27.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.55 / $22.49 / $88.01
| Facility | | $19.55 | $22.49 | $88.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.98 / $16.01 / $22.74
| Professional | | $14.98 | $16.01 | $22.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.22 / $11.56 / $11.74
| Professional | | $8.22 | $11.56 | $11.74 |