- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.87 / $89.67 / $326.86
| Facility | | $65.87 | $89.67 | $326.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.61 / $68.98 / $80.78
| Professional | | $46.61 | $68.98 | $80.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.29 / $121.35 / $191.22
| Facility | | $67.29 | $121.35 | $191.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.39 / $50.04 / $470.83
| Facility | | $40.39 | $50.04 | $470.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.93 / $58.07 / $89.31
| Professional | | $32.93 | $58.07 | $89.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.37 / $37.28 / $62.14
| Facility | | $22.37 | $37.28 | $62.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.86 / $31.07 / $93.21
| Professional | | $24.86 | $31.07 | $93.21 |