- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.72 / $98.23 / $205.04
| Facility | | $34.72 | $98.23 | $205.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.62 / $13.97 / $38.74
| Professional | | $11.62 | $13.97 | $38.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.80 / $24.61 / $26.84
| Facility | | $20.80 | $24.61 | $26.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.83 / $12.61 / $54.38
| Professional | | $8.83 | $12.61 | $54.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.18 / $12.77 / $24.88
| Professional | | $11.18 | $12.77 | $24.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.34 / $12.26 / $19.85
| Professional | | $10.34 | $12.26 | $19.85 |