- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.48 / $27.83 / $514.26
| Facility | | $8.48 | $27.83 | $514.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.47 / $28.51 / $31.22
| Professional | | $26.47 | $28.51 | $31.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.13 / $30.55 / $35.67
| Facility | | $21.13 | $30.55 | $35.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.76 / $16.76 / $33.64
| Professional | | $16.76 | $16.76 | $33.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.94 / $47.52 / $56.00
| Facility | | $33.94 | $47.52 | $56.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.32 / $44.12 / $67.88
| Professional | | $36.32 | $44.12 | $67.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.06 / $26.41 / $61.56
| Facility | | $22.06 | $26.41 | $61.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.17 / $39.24 / $218.52
| Professional | | $17.17 | $39.24 | $218.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.67 / $18.67 / $18.67
| Professional | | $18.67 | $18.67 | $18.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.65 / $27.71 / $47.43
| Professional | | $13.65 | $27.71 | $47.43 |