- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.71 / $164.92 / $370.23
| Facility | | $10.71 | $164.92 | $370.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.71 / $12.27 / $12.46
| Professional | | $10.71 | $12.27 | $12.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.59 / $73.27 / $157.22
| Facility | | $25.59 | $73.27 | $157.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.73 / $17.00 / $35.00
| Professional | | $13.73 | $17.00 | $35.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.94 / $39.78 / $108.43
| Facility | | $24.94 | $39.78 | $108.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.90 / $8.68 / $19.62
| Professional | | $6.90 | $8.68 | $19.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.71 / $15.85 / $26.84
| Facility | | $10.71 | $15.85 | $26.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $19.66 / $25.00
| Professional | | $15.00 | $19.66 | $25.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.55 / $7.55 / $10.87
| Professional | | $7.55 | $7.55 | $10.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.77 / $9.35 / $28.46
| Professional | | $5.77 | $9.35 | $28.46 |