- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.88 / $57.92 / $161.91
| Facility | | $9.88 | $57.92 | $161.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.48 / $9.65 / $19.98
| Professional | | $8.48 | $9.65 | $19.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.16 / $7.46 / $15.15
| Professional | | $7.16 | $7.46 | $15.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.17 / $22.40 / $38.79
| Facility | | $18.17 | $22.40 | $38.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.83 / $4.83 / $6.98
| Professional | | $4.83 | $4.83 | $6.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.33 / $11.36 / $28.47
| Facility | | $7.33 | $11.36 | $28.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.70 / $16.60 / $30.02
| Professional | | $13.70 | $16.60 | $30.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.09 / $13.09 / $24.33
| Facility | | $13.09 | $13.09 | $24.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.87 / $15.32 / $20.00
| Professional | | $12.87 | $15.32 | $20.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,190.64 / $1,190.64 / $1,465.39
| Facility | | $1,190.64 | $1,190.64 | $1,465.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.37 / $7.48 / $14.59
| Professional | | $5.37 | $7.48 | $14.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.03 / $125.61 / $125.61
| Facility | | $50.03 | $125.61 | $125.61 |