- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.19 / $74.59 / $104.36
| Facility | | $15.19 | $74.59 | $104.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.07 / $10.05 / $15.19
| Professional | | $9.07 | $10.05 | $15.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $10.77 / $33.74
| Facility | | $10.47 | $10.77 | $33.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.48 / $14.04 / $17.55
| Professional | | $7.48 | $14.04 | $17.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.25 / $14.09 / $53.95
| Facility | | $12.25 | $14.09 | $53.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.38 / $10.03 / $13.96
| Professional | | $9.38 | $10.03 | $13.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.15 / $7.09 / $7.35
| Professional | | $5.15 | $7.09 | $7.35 |