- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.78 / $70.88 / $192.36
| Facility | | $11.78 | $70.88 | $192.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.00 / $15.00 / $75.55
| Professional | | $11.00 | $15.00 | $75.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $39.40 / $76.83
| Facility | | $30.20 | $39.40 | $76.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.67 / $25.34 / $27.34
| Professional | | $12.67 | $25.34 | $27.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.38 / $20.43 / $38.35
| Professional | | $16.38 | $20.43 | $38.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $33.22 / $138.18
| Facility | | $10.00 | $33.22 | $138.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $42.00
| Professional | | $10.00 | $10.00 | $42.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.43 / $33.95 / $52.26
| Facility | | $20.43 | $33.95 | $52.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.02 / $37.00 / $48.03
| Professional | | $20.02 | $37.00 | $48.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.50 / $10.00 / $33.34
| Professional | | $9.50 | $10.00 | $33.34 |