- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.10 / $93.80 / $164.58
| Facility | | $10.10 | $93.80 | $164.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.77 / $8.06 / $18.04
| Professional | | $6.77 | $8.06 | $18.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $6.26 / $12.73
| Professional | | $2.48 | $6.26 | $12.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.82 / $37.60 / $37.60
| Facility | | $18.82 | $37.60 | $37.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $4.05 / $5.86
| Professional | | $4.05 | $4.05 | $5.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.15 / $9.55 / $24.02
| Facility | | $6.15 | $9.55 | $24.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.66 / $6.56 / $20.03
| Professional | | $5.66 | $6.56 | $20.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.98 / $7.86 / $17.64
| Facility | | $6.98 | $7.86 | $17.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.80 / $12.92 / $17.23
| Professional | | $8.80 | $12.92 | $17.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.21 / $223.21 / $480.75
| Facility | | $223.21 | $223.21 | $480.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $6.30 / $12.30
| Professional | | $5.01 | $6.30 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.00 / $60.00 / $100.00
| Facility | | $43.00 | $60.00 | $100.00 |