- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.73 / $30.08 / $36.09
| Facility | | $19.73 | $30.08 | $36.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.05 / $19.48 / $19.73
| Professional | | $18.05 | $19.48 | $19.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.06 / $32.47 / $39.70
| Facility | | $24.06 | $32.47 | $39.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.06 / $30.08 / $32.47
| Professional | | $24.06 | $30.08 | $32.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.55 / $37.86 / $72.18
| Facility | | $19.55 | $37.86 | $72.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $34.59 / $115.97
| Professional | | $10.00 | $34.59 | $115.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.81 / $10.83 / $29.53
| Professional | | $7.81 | $10.83 | $29.53 |