- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.79 / $97.20 / $174.60
| Facility | | $37.79 | $97.20 | $174.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.50 / $13.67 / $21.94
| Professional | | $12.50 | $13.67 | $21.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.34 / $22.50 / $25.01
| Facility | | $18.34 | $22.50 | $25.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.00 / $20.00 / $22.50
| Professional | | $20.00 | $20.00 | $22.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.55 / $30.25 / $50.03
| Facility | | $13.55 | $30.25 | $50.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $24.26 / $106.51
| Professional | | $9.44 | $24.26 | $106.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.57 / $81.26 / $136.77
| Facility | | $34.57 | $81.26 | $136.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $10.00 / $32.86
| Professional | | $7.00 | $10.00 | $32.86 |