- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.19 / $56.23 / $104.36
| Facility | | $15.19 | $56.23 | $104.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.63 / $12.72 / $18.52
| Professional | | $10.63 | $12.72 | $18.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.77 / $14.16 / $44.38
| Facility | | $13.77 | $14.16 | $44.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.48 / $18.59 / $23.23
| Professional | | $7.48 | $18.59 | $23.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.10 / $18.52 / $65.20
| Facility | | $16.10 | $18.52 | $65.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.32 / $13.02 / $18.75
| Professional | | $12.32 | $13.02 | $18.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $7.09 / $9.66
| Professional | | $6.76 | $7.09 | $9.66 |