- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.44 / $177.83 / $10,715.19
| Facility | | $23.44 | $177.83 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $15.85 / $57.54
| Professional | | $12.88 | $15.85 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $32.36
| Professional | | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $39.81 / $83.18
| Facility | | $17.78 | $39.81 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $15.14 / $25.70
| Professional | | $11.75 | $15.14 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.24 / $8.91 / $20.42
| Professional | | $7.24 | $8.91 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $10,471.29 / $25,118.86
| Facility | | $18.20 | $10,471.29 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $16.22 / $19.95
| Professional | | $15.85 | $16.22 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.51 / $18.20 / $37.15
| Facility | | $8.51 | $18.20 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.24 / $10.72 / $26.30
| Professional | | $7.24 | $10.72 | $26.30 |