- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.56 / $234.81 / $572.33
| Facility | | $53.56 | $234.81 | $572.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.07 / $6.97 / $18.35
| Professional | | $6.07 | $6.97 | $18.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.97 / $7.02 / $8.10
| Professional | | $5.97 | $7.02 | $8.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.63 / $10.18 / $17.93
| Professional | | $7.63 | $10.18 | $17.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.40 / $6.48 / $8.64
| Facility | | $5.40 | $6.48 | $8.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.40 / $6.48 / $9.28
| Professional | | $5.40 | $6.48 | $9.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.74 / $12.74 / $19.53
| Facility | | $12.74 | $12.74 | $19.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.08 / $20.77 / $73.45
| Professional | | $11.08 | $20.77 | $73.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.56 / $32.34 / $32.34
| Professional | | $7.56 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.17 / $11.70 / $18.48
| Professional | | $7.17 | $11.70 | $18.48 |