- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.16 / $114.81 / $305.33
| Facility | | $21.16 | $114.81 | $305.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.07 / $22.09 / $25.81
| Professional | | $18.07 | $22.09 | $25.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.16 / $5.16 / $32.26
| Professional | | $5.16 | $5.16 | $32.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.07 / $23.23 / $27.13
| Facility | | $16.07 | $23.23 | $27.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.64 / $12.75 / $25.58
| Professional | | $9.64 | $12.75 | $25.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.81 / $30.97 / $36.29
| Facility | | $25.81 | $30.97 | $36.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.81 / $31.23 / $51.62
| Professional | | $25.81 | $31.23 | $51.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.78 / $20.07 / $46.82
| Facility | | $16.78 | $20.07 | $46.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.04 / $29.74 / $132.19
| Professional | | $13.04 | $29.74 | $132.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.20 / $14.20 / $14.20
| Professional | | $14.20 | $14.20 | $14.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.84 / $17.84 / $33.38
| Professional | | $10.84 | $17.84 | $33.38 |