- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.44 / $21.28 / $628.66
| Facility | | $17.44 | $21.28 | $628.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.87 / $9.18 / $76.65
| Professional | | $7.87 | $9.18 | $76.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.63 / $21.54 / $26.93
| Professional | | $13.63 | $21.54 | $26.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.92 / $20.86 / $103.57
| Professional | | $11.92 | $20.86 | $103.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.92 / $19.98 / $56.98
| Facility | | $11.92 | $19.98 | $56.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $12.28 / $32.14
| Professional | | $7.15 | $12.28 | $32.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.61 / $24.28 / $37.36
| Facility | | $14.61 | $24.28 | $37.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.32 / $24.28 / $34.17
| Professional | | $14.32 | $24.28 | $34.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $10.00 / $28.86
| Professional | | $7.15 | $10.00 | $28.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.42 / $11.92 / $11.92
| Professional | | $9.42 | $11.92 | $11.92 |