- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.03 / $101.50 / $270.30
| Facility | | $23.03 | $101.50 | $270.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.03 / $26.32 / $26.77
| Professional | | $23.03 | $26.32 | $26.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.85 / $179.87 / $304.54
| Facility | | $58.85 | $179.87 | $304.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.53 / $39.00 / $74.00
| Professional | | $29.53 | $39.00 | $74.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.66 / $85.59 / $177.79
| Facility | | $53.66 | $85.59 | $177.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.95 / $18.55 / $42.33
| Professional | | $14.95 | $18.55 | $42.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.03 / $34.10 / $57.76
| Facility | | $23.03 | $34.10 | $57.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.00 / $42.30 / $54.00
| Professional | | $33.00 | $42.30 | $54.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.23 / $16.23 / $23.39
| Professional | | $16.23 | $16.23 | $23.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.40 / $20.10 / $41.26
| Professional | | $12.40 | $20.10 | $41.26 |