- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.28 / $135.21 / $481.52
| Facility | | $48.28 | $135.21 | $481.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.58 / $38.63 / $44.21
| Professional | | $10.58 | $38.63 | $44.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.83 / $31.83 / $31.83
| Facility | | $31.83 | $31.83 | $31.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.52 / $13.22 / $16.52
| Professional | | $8.52 | $13.22 | $16.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.46 / $10.46 / $10.46
| Facility | | $10.46 | $10.46 | $10.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.53 / $11.53 / $46.12
| Professional | | $11.53 | $11.53 | $46.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.36 / $44.39 / $74.42
| Facility | | $40.36 | $44.39 | $74.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.38 / $25.94 / $25.94
| Professional | | $10.38 | $25.94 | $25.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.46 / $10.46 / $40.36
| Facility | | $10.46 | $10.46 | $40.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.53 / $11.53 / $16.67
| Professional | | $11.53 | $11.53 | $16.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $23.06 / $34.79
| Professional | | $7.25 | $23.06 | $34.79 |