- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.19 / $79.59 / $104.36
| Facility | | $15.19 | $79.59 | $104.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.56 / $12.64 / $18.39
| Professional | | $10.56 | $12.64 | $18.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.68 / $14.07 / $44.09
| Facility | | $13.68 | $14.07 | $44.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.48 / $18.17 / $22.72
| Professional | | $7.48 | $18.17 | $22.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.00 / $18.39 / $64.80
| Facility | | $16.00 | $18.39 | $64.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.25 / $13.02 / $18.35
| Professional | | $12.25 | $13.02 | $18.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.72 / $6.86 / $9.60
| Professional | | $6.72 | $6.86 | $9.60 |