- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.60 / $38.15 / $82.40
| Facility | | $12.60 | $38.15 | $82.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $8.64 / $15.37
| Professional | | $8.32 | $8.64 | $15.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.22 / $30.19 / $141.03
| Facility | | $15.22 | $30.19 | $141.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $8.09 / $10.50
| Professional | | $3.50 | $8.09 | $10.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.25 / $25.13 / $47.65
| Facility | | $10.25 | $25.13 | $47.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.24 / $12.80 / $16.00
| Professional | | $6.24 | $12.80 | $16.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $18.38 / $100.47
| Professional | | $11.03 | $18.38 | $100.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.65 / $13.65 / $13.65
| Professional | | $13.65 | $13.65 | $13.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $7.20 / $13.13
| Professional | | $5.25 | $7.20 | $13.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.41 / $6.41 / $11.14
| Professional | | $4.41 | $6.41 | $11.14 |