- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.69 / $52.72 / $404.42
| Facility | | $21.69 | $52.72 | $404.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.38 / $15.66 / $21.69
| Professional | | $13.38 | $15.66 | $21.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.92 / $53.94 / $56.55
| Facility | | $45.92 | $53.94 | $56.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.20 / $12.20 / $18.98
| Professional | | $12.20 | $12.20 | $18.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.42 / $27.68 / $71.17
| Facility | | $14.42 | $27.68 | $71.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.63 / $14.22 / $39.24
| Professional | | $12.63 | $14.22 | $39.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.58 / $16.27 / $27.11
| Facility | | $13.58 | $16.27 | $27.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.62 / $27.11 / $27.11
| Professional | | $17.62 | $27.11 | $27.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.11 / $31.99 / $32.53
| Facility | | $27.11 | $31.99 | $32.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.60 / $13.56 / $27.11
| Professional | | $12.60 | $13.56 | $27.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.38 / $128.77 / $128.77
| Facility | | $43.38 | $128.77 | $128.77 |