- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.22 / $30.90 / $81.28
| Facility | | $16.22 | $30.90 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $14.13 / $33.11
| Professional | | $10.96 | $14.13 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.95 / $30.90 / $165.96
| Facility | | $19.95 | $30.90 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $11.22 / $12.30
| Professional | | $3.47 | $11.22 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $36.31 / $74.13
| Facility | | $10.47 | $36.31 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $18.62 / $24.55
| Professional | | $10.47 | $18.62 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $32.36 / $165.96
| Professional | | $17.78 | $32.36 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.89 / $20.89 / $20.89
| Professional | | $20.89 | $20.89 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $16.22 / $32.36
| Facility | | $10.47 | $16.22 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $9.77 / $16.22
| Professional | | $6.76 | $9.77 | $16.22 |