- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.30 / $157.32 / $841.19
| Facility | | $19.30 | $157.32 | $841.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.22 / $6.55 / $9.65
| Professional | | $3.22 | $6.55 | $9.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.33 / $5.88 / $11.94
| Professional | | $2.33 | $5.88 | $11.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.34 / $27.51 / $31.07
| Facility | | $14.34 | $27.51 | $31.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $5.50 / $5.50
| Professional | | $5.50 | $5.50 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.78 / $8.94 / $22.24
| Facility | | $5.78 | $8.94 | $22.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.32 / $9.19 / $11.87
| Professional | | $5.32 | $9.19 | $11.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.00 / $6.85 / $15.68
| Facility | | $6.00 | $6.85 | $15.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.72 / $11.48 / $15.00
| Professional | | $8.72 | $11.48 | $15.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,093.68 / $6,263.86 / $29,149.77
| Facility | | $6,093.68 | $6,263.86 | $29,149.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.81 / $5.47 / $10.94
| Professional | | $3.81 | $5.47 | $10.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.69 / $80.30 / $80.30
| Facility | | $34.69 | $80.30 | $80.30 |