- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.07 / $114.92 / $257.04
| Facility | | $21.07 | $114.92 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.34 / $17.16 / $60.83
| Professional | | $14.34 | $17.16 | $60.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.46 / $10.46 / $10.46
| Professional | | $10.46 | $10.46 | $10.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.76 / $29.13 / $68.03
| Facility | | $24.76 | $29.13 | $68.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.02 / $9.77 / $11.55
| Professional | | $6.02 | $9.77 | $11.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.33 / $76.76 / $102.57
| Facility | | $34.33 | $76.76 | $102.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.72 / $10.83 / $21.68
| Professional | | $7.72 | $10.83 | $21.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.43 / $26.75 / $54.85
| Professional | | $20.43 | $26.75 | $54.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $15.05 / $41.42
| Professional | | $9.02 | $15.05 | $41.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.74 / $17.86 / $24.24
| Professional | | $13.74 | $17.86 | $24.24 |