- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.98 / $51.46 / $206.10
| Facility | | $30.98 | $51.46 | $206.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.24 / $26.81 / $28.09
| Professional | | $23.24 | $26.81 | $28.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.79 / $30.98 / $38.72
| Facility | | $13.79 | $30.98 | $38.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.30 / $18.73 / $23.79
| Professional | | $15.30 | $18.73 | $23.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.14 / $36.25 / $112.18
| Facility | | $20.14 | $36.25 | $112.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.23 / $35.52 / $44.40
| Professional | | $23.23 | $35.52 | $44.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.28 / $30.98 / $32.53
| Professional | | $0.28 | $30.98 | $32.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.65 / $10.65 / $10.65
| Professional | | $10.65 | $10.65 | $10.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.47 / $46.47 / $46.47
| Facility | | $46.47 | $46.47 | $46.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.01 / $18.18 / $38.25
| Professional | | $13.01 | $18.18 | $38.25 |