- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.80 / $40.44 / $107.98
| Facility | | $14.80 | $40.44 | $107.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.13 / $14.88 / $15.71
| Professional | | $11.13 | $14.88 | $15.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.27 / $10.27 / $11.89
| Professional | | $10.27 | $10.27 | $11.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.02 / $72.98 / $108.13
| Facility | | $65.02 | $72.98 | $108.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.86 / $32.34 / $32.34
| Professional | | $21.86 | $32.34 | $32.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.25 / $22.02 / $94.84
| Facility | | $11.25 | $22.02 | $94.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.49 / $24.78 / $82.00
| Professional | | $10.49 | $24.78 | $82.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.94 / $14.94 / $37.11
| Facility | | $14.94 | $14.94 | $37.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.19 / $12.66 / $34.92
| Professional | | $7.19 | $12.66 | $34.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.08 / $47.08 / $47.08
| Facility | | $47.08 | $47.08 | $47.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.56 / $10.27 / $15.14
| Professional | | $8.56 | $10.27 | $15.14 |