- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.69 / $62.85 / $216.86
| Facility | | $22.69 | $62.85 | $216.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.39 / $25.37 / $35.82
| Professional | | $22.39 | $25.37 | $35.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.55 / $86.27 / $136.71
| Facility | | $31.55 | $86.27 | $136.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.53 / $12.53 / $22.92
| Professional | | $12.53 | $12.53 | $22.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.46 / $28.52 / $76.81
| Facility | | $17.46 | $28.52 | $76.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.64 / $21.92 / $42.85
| Professional | | $13.64 | $21.92 | $42.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.69 / $26.66 / $54.07
| Facility | | $22.69 | $26.66 | $54.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.00 / $38.81 / $110.15
| Professional | | $20.00 | $38.81 | $110.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.54 / $37.54 / $37.54
| Facility | | $37.54 | $37.54 | $37.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.54 / $17.52 / $22.09
| Professional | | $12.54 | $17.52 | $22.09 |