- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $33.88 / $107.15
| Facility | | $16.60 | $33.88 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $14.13 / $34.67
| Professional | | $12.02 | $14.13 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $11.48 / $26.92
| Professional | | $11.22 | $11.48 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $19.95 / $24.55
| Facility | | $12.02 | $19.95 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $10.47 / $25.70
| Professional | | $7.41 | $10.47 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $26.92
| Facility | | $12.02 | $12.02 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $18.62
| Professional | | $12.02 | $12.02 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $36.31 / $57.54
| Facility | | $18.20 | $36.31 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.51 / $22.91 / $28.18
| Professional | | $8.51 | $22.91 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $26.30 / $363.08
| Professional | | $20.42 | $26.30 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $16.60 / $18.62
| Facility | | $8.32 | $16.60 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $11.22 / $32.36
| Professional | | $7.76 | $11.22 | $32.36 |