- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.38 / $126.82 / $602.67
| Facility | | $15.38 | $126.82 | $602.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.42 / $6.92 / $11.92
| Professional | | $6.42 | $6.92 | $11.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.18 / $71.62 / $128.88
| Facility | | $26.18 | $71.62 | $128.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $11.00 / $22.00
| Professional | | $7.00 | $11.00 | $22.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.59 / $25.15 / $53.34
| Facility | | $4.59 | $25.15 | $53.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.44 / $6.68 / $24.63
| Professional | | $4.44 | $6.68 | $24.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.77 / $10.02 / $16.98
| Facility | | $6.77 | $10.02 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.00 / $11.48 / $16.00
| Professional | | $9.00 | $11.48 | $16.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.76 / $4.76 / $6.87
| Professional | | $4.76 | $4.76 | $6.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.65 / $5.21 / $10.42
| Professional | | $3.65 | $5.21 | $10.42 |