- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.21 / $140.75 / $191.10
| Facility | | $24.21 | $140.75 | $191.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.92 / $10.84 / $15.26
| Professional | | $8.92 | $10.84 | $15.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.30 / $10.59 / $33.19
| Facility | | $10.30 | $10.59 | $33.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.64 / $13.63 / $17.04
| Professional | | $7.64 | $13.63 | $17.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.05 / $13.86 / $54.23
| Facility | | $12.05 | $13.86 | $54.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.23 / $9.76 / $13.96
| Professional | | $9.23 | $9.76 | $13.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $7.12 / $7.23
| Professional | | $5.05 | $7.12 | $7.23 |