- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.88 / $52.87 / $138.35
| Facility | | $28.88 | $52.87 | $138.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.37 / $28.87 / $51.78
| Professional | | $18.37 | $28.87 | $51.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.01 / $28.34 / $35.78
| Facility | | $24.01 | $28.34 | $35.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.05 / $18.05 / $33.58
| Professional | | $18.05 | $18.05 | $33.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.51 / $42.11 / $74.03
| Facility | | $16.51 | $42.11 | $74.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.71 / $19.50 / $34.59
| Professional | | $12.71 | $19.50 | $34.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.42 / $22.66 / $34.90
| Professional | | $8.42 | $22.66 | $34.90 |