- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.77 / $43.86 / $52.64
| Facility | | $28.77 | $43.86 | $52.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.32 / $28.77 / $29.83
| Professional | | $26.32 | $28.77 | $29.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.37 / $197.38 / $947.44
| Facility | | $47.37 | $197.38 | $947.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.11 / $47.37 / $119,998.80
| Professional | | $42.11 | $47.37 | $119,998.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.51 / $42.11 / $105.27
| Facility | | $28.51 | $42.11 | $105.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.13 / $169.13 / $169.13
| Professional | | $169.13 | $169.13 | $169.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.05 / $21.05 / $21.05
| Facility | | $21.05 | $21.05 | $21.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.74 / $15.79 / $50.88
| Professional | | $14.74 | $15.79 | $50.88 |