- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.44 / $57.04 / $389.34
| Facility | | $14.44 | $57.04 | $389.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.44 / $15.63 / $24.78
| Professional | | $14.44 | $15.63 | $24.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.04 / $12.54 / $80.33
| Professional | | $12.04 | $12.54 | $80.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.65 / $75.30 / $75.30
| Facility | | $37.65 | $75.30 | $75.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $8.11 / $12.64
| Professional | | $8.11 | $8.11 | $12.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.32 / $19.10 / $47.15
| Facility | | $12.32 | $19.10 | $47.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $13.31 / $25.81
| Professional | | $11.48 | $13.31 | $25.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.44 / $15.74 / $35.32
| Facility | | $14.44 | $15.74 | $35.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.05 / $25.86 / $33.00
| Professional | | $11.05 | $25.86 | $33.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $12.62 / $24.63
| Professional | | $9.44 | $12.62 | $24.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.45 / $137.69 / $137.69
| Facility | | $50.45 | $137.69 | $137.69 |