- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.78 / $234.06 / $285.70
| Facility | | $19.78 | $234.06 | $285.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.36 / $12.97 / $14.57
| Professional | | $11.36 | $12.97 | $14.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.74 / $8.74 / $8.74
| Professional | | $8.74 | $8.74 | $8.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.49 / $14.57 / $18.21
| Facility | | $6.49 | $14.57 | $18.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.20 / $8.81 / $11.18
| Professional | | $7.20 | $8.81 | $11.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.47 / $17.05 / $52.75
| Facility | | $9.47 | $17.05 | $52.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.98 / $16.93 / $21.17
| Professional | | $10.98 | $16.93 | $21.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.21 / $14.57 / $15.30
| Professional | | $0.21 | $14.57 | $15.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $5.01 / $5.01
| Professional | | $5.01 | $5.01 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.12 / $8.55 / $14.57
| Professional | | $6.12 | $8.55 | $14.57 |