- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.76 / $95.63 / $428.53
| Facility | | $22.76 | $95.63 | $428.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.76 / $22.76 / $32.78
| Professional | | $22.76 | $22.76 | $32.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.19 / $37.51 / $274.79
| Facility | | $27.19 | $37.51 | $274.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.24 / $11.24 / $31.43
| Professional | | $11.24 | $11.24 | $31.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.29 / $39.17 / $59.95
| Facility | | $33.29 | $39.17 | $59.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.48 / $36.97 / $40.56
| Professional | | $28.48 | $36.97 | $40.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.10 / $28.10 / $34.03
| Professional | | $28.10 | $28.10 | $34.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.31 / $119.26 / $428.53
| Facility | | $27.31 | $119.26 | $428.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.76 / $28.10 / $32.78
| Professional | | $22.76 | $28.10 | $32.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.86 / $22.21 / $53.68
| Professional | | $16.86 | $22.21 | $53.68 |