- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.65 / $59.22 / $484.80
| Facility | | $13.65 | $59.22 | $484.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.31 / $11.08 / $17.04
| Professional | | $9.31 | $11.08 | $17.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.45 / $7.45 / $7.45
| Professional | | $7.45 | $7.45 | $7.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.52 / $12.41 / $15.51
| Facility | | $5.52 | $12.41 | $15.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.13 / $7.50 / $9.52
| Professional | | $6.13 | $7.50 | $9.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.07 / $14.53 / $44.95
| Facility | | $8.07 | $14.53 | $44.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $14.04 / $17.55
| Professional | | $9.36 | $14.04 | $17.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.18 / $12.41 / $13.03
| Professional | | $0.18 | $12.41 | $13.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.26 / $4.26 / $4.26
| Professional | | $4.26 | $4.26 | $4.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.21 / $7.28 / $15.32
| Professional | | $5.21 | $7.28 | $15.32 |