- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.48 / $177.28 / $324.80
| Facility | | $27.48 | $177.28 | $324.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.76 / $17.53 / $19.63
| Professional | | $12.76 | $17.53 | $19.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.30 / $11.78 / $29.45
| Professional | | $5.30 | $11.78 | $29.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.52 / $61.87 / $206.38
| Facility | | $28.52 | $61.87 | $206.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $14.36 / $15.12
| Professional | | $3.50 | $14.36 | $15.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.51 / $47.76 / $90.83
| Facility | | $20.51 | $47.76 | $90.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.12 / $23.95 / $29.94
| Professional | | $14.12 | $23.95 | $29.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.02 / $34.35 / $282.16
| Professional | | $20.02 | $34.35 | $282.16 |
- 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
- $25.52 / $25.52 / $25.52
| Professional | | $25.52 | $25.52 | $25.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.21 / $12.95 / $24.54
| Professional | | $7.21 | $12.95 | $24.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.24 / $12.60 / $19.63
| Professional | | $8.24 | $12.60 | $19.63 |