- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.01 / $94.05 / $185.60
| Facility | | $21.01 | $94.05 | $185.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.23 / $22.09 / $42.21
| Professional | | $16.23 | $22.09 | $42.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.45 / $12.91 / $17.93
| Professional | | $6.45 | $12.91 | $17.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.43 / $69.06 / $100.04
| Facility | | $51.43 | $69.06 | $100.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.52 / $24.52 / $26.38
| Professional | | $24.52 | $24.52 | $26.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.78 / $18.04 / $42.17
| Facility | | $16.78 | $18.04 | $42.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.53 / $25.97 / $37.17
| Professional | | $11.53 | $25.97 | $37.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.51 / $25.81 / $123.84
| Facility | | $22.51 | $25.81 | $123.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.84 / $14.91 / $34.07
| Professional | | $10.84 | $14.91 | $34.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.55 / $111.55 / $159.52
| Facility | | $111.55 | $111.55 | $159.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.84 / $12.91 / $16.78
| Professional | | $10.84 | $12.91 | $16.78 |