- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.59 / $126.00 / $299.74
| Facility | | $8.59 | $126.00 | $299.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.70 / $6.24 / $8.17
| Professional | | $2.70 | $6.24 | $8.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.45 / $5.68 / $6.14
| Professional | | $5.45 | $5.68 | $6.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.05 / $33.40 / $33.40
| Facility | | $17.05 | $33.40 | $33.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.68 / $3.68 / $5.72
| Professional | | $3.68 | $3.68 | $5.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.58 / $8.65 / $21.35
| Facility | | $5.58 | $8.65 | $21.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.16 / $6.02 / $11.87
| Professional | | $5.16 | $6.02 | $11.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.09 / $6.62 / $15.68
| Facility | | $6.09 | $6.62 | $15.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.17 / $11.48 / $15.00
| Professional | | $10.17 | $11.48 | $15.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,668.26 / $2,915.21 / $10,156.07
| Facility | | $2,668.26 | $2,915.21 | $10,156.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.15 / $6.04 / $8.17
| Facility | | $3.15 | $6.04 | $8.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.68 / $5.47 / $10.94
| Professional | | $3.68 | $5.47 | $10.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.80 / $65.64 / $65.64
| Facility | | $26.80 | $65.64 | $65.64 |