- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.52 / $31.08 / $503.37
| Facility | | $15.52 | $31.08 | $503.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $15.00 / $30.14
| Professional | | $11.22 | $15.00 | $30.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.11 / $10.11 / $10.11
| Professional | | $10.11 | $10.11 | $10.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.18 / $21.55 / $58.37
| Facility | | $12.18 | $21.55 | $58.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.24 / $8.33 / $33.79
| Professional | | $6.24 | $8.33 | $33.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.51 / $16.87 / $26.99
| Facility | | $11.51 | $16.87 | $26.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.77 / $37.11 / $52.29
| Facility | | $16.77 | $37.11 | $52.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.39 / $20.65 / $25.81
| Professional | | $10.39 | $20.65 | $25.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.43 / $23.96 / $247.69
| Professional | | $18.43 | $23.96 | $247.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.27 / $110.27 / $110.27
| Facility | | $110.27 | $110.27 | $110.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.90 / $13.81 / $30.82
| Professional | | $9.90 | $13.81 | $30.82 |