- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.46 / $74.66 / $219.87
| Facility | | $9.46 | $74.66 | $219.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.66 / $7.66 / $12.99
| Professional | | $7.66 | $7.66 | $12.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.15 / $12.63 / $98.66
| Facility | | $9.15 | $12.63 | $98.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.78 / $3.78 / $10.93
| Professional | | $3.78 | $3.78 | $10.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.10 / $13.06 / $20.18
| Facility | | $11.10 | $13.06 | $20.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.49 / $11.65 / $13.64
| Professional | | $9.49 | $11.65 | $13.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.46 / $9.46 / $11.46
| Professional | | $9.46 | $9.46 | $11.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.46 / $23.65 / $162.47
| Facility | | $9.46 | $23.65 | $162.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.66 / $10.40 / $18.84
| Professional | | $7.66 | $10.40 | $18.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.68 / $7.73 / $18.68
| Professional | | $5.68 | $7.73 | $18.68 |