- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.42 / $87.40 / $194.48
| Facility | | $32.42 | $87.40 | $194.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.50 / $12.94 / $24.32
| Professional | | $11.50 | $12.94 | $24.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.17 / $13.22 / $48.66
| Facility | | $12.17 | $13.22 | $48.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.08 / $14.46 / $18.07
| Professional | | $6.08 | $14.46 | $18.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.00 / $25.54 / $205.94
| Facility | | $11.00 | $25.54 | $205.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.47 / $12.47 / $14.96
| Professional | | $12.47 | $12.47 | $14.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.47 / $12.47 / $12.47
| Professional | | $12.47 | $12.47 | $12.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.71 / $28.06 / $45.89
| Facility | | $18.71 | $28.06 | $45.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $21.53 / $21.66
| Professional | | $10.60 | $21.53 | $21.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.24 / $5.85 / $16.20
| Professional | | $5.24 | $5.85 | $16.20 |