- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.63 / $35.93 / $92.40
| Facility | | $19.63 | $35.93 | $92.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.46 / $12.53 / $19.28
| Professional | | $10.46 | $12.53 | $19.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.32 / $18.93 / $24.31
| Facility | | $16.32 | $18.93 | $24.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $12.05 / $20.72
| Professional | | $12.05 | $12.05 | $20.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.26 / $28.62 / $50.31
| Facility | | $11.26 | $28.62 | $50.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.59 / $12.67 / $23.23
| Professional | | $8.59 | $12.67 | $23.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $16.07 / $23.71
| Professional | | $5.62 | $16.07 | $23.71 |