- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.96 / $145.06 / $316.83
| Facility | | $23.96 | $145.06 | $316.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.34 / $10.71 / $12.70
| Professional | | $9.34 | $10.71 | $12.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.24 / $10.54 / $33.02
| Facility | | $10.24 | $10.54 | $33.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.48 / $13.63 / $17.04
| Professional | | $7.48 | $13.63 | $17.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.98 / $13.78 / $53.95
| Facility | | $11.98 | $13.78 | $53.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.17 / $9.76 / $13.96
| Professional | | $9.17 | $9.76 | $13.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.03 / $5.03 / $7.19
| Professional | | $5.03 | $5.03 | $7.19 |