- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.91 / $114.52 / $290.77
| Facility | | $27.91 | $114.52 | $290.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.40 / $16.72 / $55.04
| Professional | | $12.40 | $16.72 | $55.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.40 / $9.40 / $9.40
| Professional | | $9.40 | $9.40 | $9.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.95 / $58.64 / $114.35
| Facility | | $44.95 | $58.64 | $114.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.27 / $28.55 / $30.82
| Professional | | $14.27 | $28.55 | $30.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.48 / $26.85 / $42.43
| Professional | | $21.48 | $26.85 | $42.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.27 / $36.84 / $133.19
| Facility | | $11.27 | $36.84 | $133.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.27 / $11.27 / $47.00
| Professional | | $11.27 | $11.27 | $47.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.02 / $37.20 / $58.91
| Facility | | $23.02 | $37.20 | $58.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.57 / $41.76 / $54.14
| Professional | | $22.57 | $41.76 | $54.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.71 / $11.27 / $37.58
| Professional | | $10.71 | $11.27 | $37.58 |