- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.13 / $108.37 / $233.14
| Facility | | $16.13 | $108.37 | $233.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.79 / $16.37 / $22.07
| Professional | | $13.79 | $16.37 | $22.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.68 / $9.19 / $12.78
| Professional | | $3.68 | $9.19 | $12.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.45 / $16.55 / $19.32
| Facility | | $11.45 | $16.55 | $19.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.08 / $10.42 / $18.23
| Professional | | $9.08 | $10.42 | $18.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.39 / $22.07 / $25.87
| Facility | | $18.39 | $22.07 | $25.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.39 / $22.25 / $36.78
| Professional | | $18.39 | $22.25 | $36.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.95 / $14.31 / $33.36
| Facility | | $11.95 | $14.31 | $33.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.41 / $21.06 / $117.52
| Professional | | $9.41 | $21.06 | $117.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.11 / $10.11 / $10.11
| Professional | | $10.11 | $10.11 | $10.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.72 / $15.42 / $25.70
| Professional | | $7.72 | $15.42 | $25.70 |