- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.65 / $100.01 / $120.02
| Facility | | $21.65 | $100.01 | $120.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.82 / $11.69 / $11.83
| Professional | | $10.82 | $11.69 | $11.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.87 / $19.48 / $21.65
| Facility | | $15.87 | $19.48 | $21.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.32 / $17.32 / $19.48
| Professional | | $17.32 | $17.32 | $19.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.73 / $25.75 / $43.29
| Facility | | $11.73 | $25.75 | $43.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $21.17 / $78.94
| Professional | | $6.76 | $21.17 | $78.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $6.75 / $21.71
| Professional | | $6.46 | $6.75 | $21.71 |