- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.85 / $94.86 / $220.15
| Facility | | $13.85 | $94.86 | $220.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.01 / $13.55 / $43.30
| Professional | | $8.01 | $13.55 | $43.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.70 / $10.46 / $21.25
| Professional | | $6.70 | $10.46 | $21.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.05 / $36.49 / $36.49
| Facility | | $30.05 | $36.49 | $36.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.77 / $6.77 / $9.77
| Professional | | $6.77 | $6.77 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.27 / $15.92 / $39.14
| Facility | | $10.27 | $15.92 | $39.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.48 / $11.12 / $21.68
| Professional | | $9.48 | $11.12 | $21.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.65 / $13.65 / $17.91
| Facility | | $11.65 | $13.65 | $17.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.49 / $12.53 / $16.00
| Professional | | $10.49 | $12.53 | $16.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $664.54 / $685.57 / $1,486.63
| Facility | | $664.54 | $685.57 | $1,486.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $9.02 / $15.50
| Professional | | $7.94 | $9.02 | $15.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.14 / $76.47 / $100.00
| Facility | | $60.14 | $76.47 | $100.00 |