- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.73 / $71.27 / $124.61
| Facility | | $25.73 | $71.27 | $124.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.32 / $25.73 / $31.83
| Professional | | $20.32 | $25.73 | $31.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.78 / $94.47 / $155.76
| Facility | | $35.78 | $94.47 | $155.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.22 / $14.22 / $33.86
| Professional | | $14.22 | $14.22 | $33.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.37 / $22.67 / $103.45
| Facility | | $19.37 | $22.67 | $103.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.47 / $41.47 / $49.10
| Professional | | $41.47 | $41.47 | $49.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.73 / $36.02 / $47.40
| Facility | | $25.73 | $36.02 | $47.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.09 / $48.08 / $124.94
| Professional | | $27.09 | $48.08 | $124.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.47 / $30.47 / $30.47
| Facility | | $30.47 | $30.47 | $30.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.22 / $14.22 / $20.32
| Professional | | $14.22 | $14.22 | $20.32 |