- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $53.70 / $331.13
| Facility | | $5.89 | $53.70 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $6.76 / $21.88
| Professional | | $5.50 | $6.76 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.24 / $5.25 / $10.47
| Professional | | $3.24 | $5.25 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $47.86 / $107.15
| Facility | | $16.98 | $47.86 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $12.02 / $24.55
| Professional | | $10.00 | $12.02 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.90 / $19.05 / $61.66
| Facility | | $4.90 | $19.05 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $4.79 / $10.96
| Professional | | $3.47 | $4.79 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $8.71 / $19.95
| Facility | | $5.89 | $8.71 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.76 / $7.59 / $9.12
| Facility | | $6.76 | $7.59 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $4.68 / $10.47
| Professional | | $3.16 | $4.68 | $10.47 |