- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $114.82 / $602.56
| Facility | | $18.20 | $114.82 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $14.13 / $46.77
| Professional | | $12.30 | $14.13 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $11.48 / $11.48
| Professional | | $11.48 | $11.48 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $75.86 / $186.21
| Facility | | $29.51 | $75.86 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $19.95 / $25.70
| Professional | | $18.20 | $19.95 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $46.77 / $114.82
| Facility | | $12.02 | $46.77 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $8.51 / $26.30
| Professional | | $8.32 | $8.51 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $19.50 / $43.65
| Facility | | $12.88 | $19.50 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $18.20 / $21.88
| Facility | | $16.60 | $18.20 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $10.96 / $20.42
| Professional | | $7.76 | $10.96 | $20.42 |