- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.23 / $54.95 / $398.11
| Facility | | $10.23 | $54.95 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $6.76 / $10.96
| Professional | | $5.50 | $6.76 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.63 / $4.27 / $8.51
| Professional | | $3.63 | $4.27 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $18.62 / $31.62
| Facility | | $10.47 | $18.62 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $9.33 / $14.45
| Professional | | $7.08 | $9.33 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.51 / $8.51 / $39.81
| Facility | | $8.51 | $8.51 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $16.22 / $51.29
| Facility | | $5.50 | $16.22 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.47 / $5.62 / $10.00
| Professional | | $4.47 | $5.62 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.80 / $8.51 / $10.72
| Facility | | $3.80 | $8.51 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $4.47 / $11.75
| Professional | | $3.47 | $4.47 | $11.75 |