- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.61 / $205.21 / $680.96
| Facility | | $32.61 | $205.21 | $680.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.42 / $26.42 / $44.79
| Professional | | $26.42 | $26.42 | $44.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.57 / $43.55 / $340.71
| Facility | | $31.57 | $43.55 | $340.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.05 / $13.05 / $37.72
| Professional | | $13.05 | $13.05 | $37.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.65 / $69.56 / $75.72
| Facility | | $44.65 | $69.56 | $75.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.06 / $44.39 / $71.31
| Professional | | $33.06 | $44.39 | $71.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.61 / $32.61 / $39.50
| Professional | | $32.61 | $32.61 | $39.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.61 / $70.06 / $630.59
| Facility | | $32.61 | $70.06 | $630.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.42 / $32.61 / $44.79
| Professional | | $26.42 | $32.61 | $44.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.57 / $26.66 / $64.42
| Professional | | $19.57 | $26.66 | $64.42 |