- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.67 / $94.72 / $321.52
| Facility | | $11.67 | $94.72 | $321.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.44 / $6.92 / $9.40
| Professional | | $5.44 | $6.92 | $9.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $5.39 / $17.48
| Professional | | $2.14 | $5.39 | $17.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.17 / $16.22 / $26.71
| Facility | | $13.17 | $16.22 | $26.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $5.05
| Professional | | $5.05 | $5.05 | $5.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.30 / $8.22 / $20.46
| Facility | | $5.30 | $8.22 | $20.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.99 / $8.36 / $11.36
| Professional | | $4.99 | $8.36 | $11.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.83 / $6.22 / $15.20
| Facility | | $5.83 | $6.22 | $15.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.63 / $10.69 / $15.00
| Professional | | $5.63 | $10.69 | $15.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,382.88 / $2,603.40 / $8,909.18
| Facility | | $2,382.88 | $2,603.40 | $8,909.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $5.43 / $10.61
| Professional | | $3.55 | $5.43 | $10.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.14 / $60.00 / $100.00
| Facility | | $42.14 | $60.00 | $100.00 |