- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.85 / $5,248.07 / $10,471.29
| Facility | | $15.85 | $5,248.07 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $12.02 / $21.88
| Professional | | $6.03 | $12.02 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.37 / $12.88 / $16.60
| Professional | | $5.37 | $12.88 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.70 / $70.79 / $114.82
| Facility | | $53.70 | $70.79 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $10.72 / $20.42
| Professional | | $10.72 | $10.72 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $14.45 / $26.92
| Professional | | $8.13 | $14.45 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $24.55 / $1,258.93
| Facility | | $9.33 | $24.55 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $20.42 / $131.83
| Professional | | $13.80 | $20.42 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $407.38 / $1,778.28
| Facility | | $44.67 | $407.38 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $14.13 / $21.88
| Professional | | $7.94 | $14.13 | $21.88 |