- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $162.18 / $758.58
| Facility | | $29.51 | $162.18 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $7.08 / $33.88
| Professional | | $6.03 | $7.08 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $5.13 / $12.59
| Professional | | $3.98 | $5.13 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $10.47 / $33.88
| Facility | | $5.89 | $10.47 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $8.91 / $12.88
| Professional | | $5.62 | $8.91 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.71 / $40.74 / $75.86
| Facility | | $8.71 | $40.74 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $11.75 / $13.80
| Professional | | $3.80 | $11.75 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $4.27 / $5.62
| Professional | | $1.00 | $4.27 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.55 / $5.62 / $10.47
| Facility | | $3.55 | $5.62 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $5.01 / $11.75
| Professional | | $3.16 | $5.01 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $5.25 / $8.32
| Professional | | $5.25 | $5.25 | $8.32 |