- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.90 / $86.40 / $194.79
| Facility | | $15.90 | $86.40 | $194.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.88 / $14.32 / $26.26
| Professional | | $11.88 | $14.32 | $26.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.63 / $11.15 / $22.66
| Professional | | $9.63 | $11.15 | $22.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.15 / $55.18 / $62.32
| Facility | | $27.15 | $55.18 | $62.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.23 / $10.44 / $18.26
| Professional | | $7.23 | $10.44 | $18.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $17.00 / $41.81
| Facility | | $10.96 | $17.00 | $41.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.15 / $11.85 / $23.23
| Professional | | $10.15 | $11.85 | $23.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.55 / $14.00 / $31.42
| Facility | | $12.55 | $14.00 | $31.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.89 / $23.01 / $30.00
| Professional | | $12.89 | $23.01 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.08 / $315.08 / $315.08
| Facility | | $315.08 | $315.08 | $315.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.75 / $10.96 / $21.91
| Professional | | $6.75 | $10.96 | $21.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.35 / $124.96 / $124.96
| Facility | | $39.35 | $124.96 | $124.96 |