- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.23 / $38.38 / $211.52
| Facility | | $28.23 | $38.38 | $211.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.23 / $29.31 / $38.38
| Professional | | $28.23 | $29.31 | $38.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.25 / $32.17 / $37.56
| Facility | | $22.25 | $32.17 | $37.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $14.30 / $24.66
| Professional | | $10.72 | $14.30 | $24.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.74 / $42.89 / $50.04
| Facility | | $35.74 | $42.89 | $50.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.74 / $43.24 / $71.48
| Professional | | $35.74 | $43.24 | $71.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.23 / $27.27 / $50.62
| Facility | | $23.23 | $27.27 | $50.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.35 / $40.20 / $172.27
| Professional | | $16.35 | $40.20 | $172.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.66 / $19.66 / $19.66
| Professional | | $19.66 | $19.66 | $19.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.01 / $22.45 / $39.31
| Professional | | $15.01 | $22.45 | $39.31 |