- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.42 / $72.16 / $138.46
| Facility | | $39.42 | $72.16 | $138.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.65 / $20.04 / $24.08
| Professional | | $15.65 | $20.04 | $24.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.36 / $29.62 / $32.77
| Facility | | $28.36 | $29.62 | $32.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.05 / $18.05 / $45.85
| Professional | | $18.05 | $18.05 | $45.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.48 / $78.90 / $101.04
| Facility | | $57.48 | $78.90 | $101.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.36 / $27.67 / $34.59
| Professional | | $17.36 | $27.67 | $34.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.43 / $17.05 / $47.64
| Professional | | $8.43 | $17.05 | $47.64 |