- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.05 / $527.52
| Facility | | $0.02 | $0.05 | $527.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.10 / $48.07 / $94.28
| Facility | | $12.10 | $48.07 | $94.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.53 / $18.22 / $25.97
| Professional | | $12.53 | $18.22 | $25.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.06 / $1.54 / $2.12
| Facility | | $1.06 | $1.54 | $2.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.69 / $19.38 / $20.61
| Professional | | $15.69 | $19.38 | $20.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.34 / $112.04 / $112.04
| Facility | | $23.34 | $112.04 | $112.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.35 / $10.16 / $14.51
| Professional | | $6.35 | $10.16 | $14.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.21 / $10.16 / $14.51
| Professional | | $6.21 | $10.16 | $14.51 |