- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.00 / $141.51 / $764.00
| Facility | | $22.00 | $141.51 | $764.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.20 / $13.48 / $16.22
| Professional | | $12.20 | $13.48 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.49 / $65.31 / $234.56
| Facility | | $22.49 | $65.31 | $234.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $17.85 / $25.49
| Professional | | $15.00 | $17.85 | $25.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.89 / $54.06 / $112.60
| Facility | | $33.89 | $54.06 | $112.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.50 / $10.53 / $42.67
| Professional | | $8.50 | $10.53 | $42.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.17 / $17.23 / $25.23
| Facility | | $13.17 | $17.23 | $25.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $18.82 / $23.00
| Professional | | $15.00 | $18.82 | $23.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.25 / $10.25 / $14.76
| Professional | | $10.25 | $10.25 | $14.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.83 / $11.18 / $22.37
| Professional | | $7.83 | $11.18 | $22.37 |