- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.38 / $172.96 / $906.48
| Facility | | $8.38 | $172.96 | $906.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.27 / $14.47 / $23.85
| Professional | | $8.27 | $14.47 | $23.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.91 / $15.91 / $17.11
| Professional | | $15.91 | $15.91 | $17.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.08 / $7.23 / $23.84
| Facility | | $5.08 | $7.23 | $23.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $14.29 / $28.25
| Professional | | $10.00 | $14.29 | $28.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.91 / $54.30 / $58.72
| Facility | | $50.91 | $54.30 | $58.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.98 / $12.83 / $25.88
| Professional | | $11.98 | $12.83 | $25.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.16 / $26.73 / $32.11
| Professional | | $24.16 | $26.73 | $32.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.51 / $20.01 / $35.26
| Professional | | $14.51 | $20.01 | $35.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.45 / $14.91 / $14.91
| Professional | | $7.45 | $14.91 | $14.91 |