- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.34 / $94.68 / $966.42
| Facility | | $13.34 | $94.68 | $966.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.34 / $22.89 / $75.55
| Professional | | $13.34 | $22.89 | $75.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.58 / $11.58 / $11.58
| Professional | | $4.58 | $11.58 | $11.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.78 / $69.55 / $69.55
| Facility | | $34.78 | $69.55 | $69.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.50 / $10.84 / $18.88
| Professional | | $7.50 | $10.84 | $18.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.38 / $17.63 / $43.59
| Facility | | $11.38 | $17.63 | $43.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.65 / $12.21 / $24.26
| Professional | | $10.65 | $12.21 | $24.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.34 / $15.12 / $32.61
| Facility | | $13.34 | $15.12 | $32.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.72 / $23.88 / $31.00
| Professional | | $22.72 | $23.88 | $31.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.50 / $11.38 / $22.76
| Professional | | $7.50 | $11.38 | $22.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.48 / $138.18 / $138.18
| Facility | | $46.48 | $138.18 | $138.18 |