- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.44 / $64.57 / $128.82
| Facility | | $23.44 | $64.57 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $28.84 / $61.66
| Professional | | $16.98 | $28.84 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,467.37 / $8,511.38
| Facility | | $2,454.71 | $3,467.37 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $26.30 / $50.12
| Professional | | $20.42 | $26.30 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $34.67 / $66.07 / $104.71
| Professional | 50 | $34.67 | $66.07 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $44.67 / $77.62
| Professional | | $22.91 | $44.67 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.49 / $29.51 / $81.28
| Professional | | $15.49 | $29.51 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.49 / $29.51 / $32.36
| Professional | | $15.49 | $29.51 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,479.11 / $2,691.53
| Facility | | $676.08 | $1,479.11 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $48.98 / $77.62
| Professional | | $25.12 | $48.98 | $77.62 |