- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.53 / $82.28 / $277.10
| Facility | | $16.53 | $82.28 | $277.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.03 / $5.84 / $6.70
| Professional | | $5.03 | $5.84 | $6.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.35 / $4.01 / $4.65
| Professional | | $3.35 | $4.01 | $4.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.63 / $7.19 / $17.23
| Facility | | $4.63 | $7.19 | $17.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.45 / $7.58 / $10.33
| Professional | | $4.45 | $7.58 | $10.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.67 / $38.11 / $61.43
| Facility | | $6.67 | $38.11 | $61.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.01 / $4.63 / $9.36
| Professional | | $4.01 | $4.63 | $9.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.22 / $3.54 / $4.42
| Professional | | $3.22 | $3.54 | $4.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.42 / $4.01 / $6.03
| Facility | | $3.42 | $4.01 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.68 / $4.01 / $10.50
| Professional | | $2.68 | $4.01 | $10.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $4.01 / $4.01
| Professional | | $3.47 | $4.01 | $4.01 |