- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.65 / $330.52 / $491.18
| Facility | | $32.65 | $330.52 | $491.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.97 / $20.42 / $31.28
| Professional | | $17.97 | $20.42 | $31.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.23 / $21.78 / $29.08
| Professional | | $19.23 | $21.78 | $29.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.90 / $17.89 / $35.22
| Facility | | $12.90 | $17.89 | $35.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.90 / $28.45 / $93.46
| Professional | | $12.90 | $28.45 | $93.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.22 / $34.03 / $40.83
| Professional | | $27.22 | $34.03 | $40.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.43 / $13.61 / $20.69
| Professional | | $11.43 | $13.61 | $20.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.62 / $13.61 / $26.30
| Professional | | $10.62 | $13.61 | $26.30 |