- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $120.23 / $158.49
| Facility | | $21.88 | $120.23 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $14.13 / $21.88
| Professional | | $10.96 | $14.13 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $15.49 / $48.98
| Facility | | $15.14 | $15.49 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $20.42 / $33.88
| Professional | | $10.96 | $20.42 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $64.57 / $93.33
| Facility | | $17.78 | $64.57 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $15.14 / $15.85
| Professional | | $12.02 | $15.14 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $17.78 / $56.23
| Professional | | $12.30 | $17.78 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.49 / $17.78 / $26.30
| Professional | | $15.49 | $17.78 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $8.91 / $11.48
| Facility | | $8.91 | $8.91 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $10.47 / $24.55
| Professional | | $7.41 | $10.47 | $24.55 |