- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.36 / $134.33 / $341.10
| Facility | | $74.36 | $134.33 | $341.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.46 / $59.97 / $74.95
| Professional | | $16.46 | $59.97 | $74.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.47 / $49.47 / $49.47
| Facility | | $49.47 | $49.47 | $49.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.07 / $20.65 / $25.81
| Professional | | $13.07 | $20.65 | $25.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.23 / $16.23 / $16.23
| Facility | | $16.23 | $16.23 | $16.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.89 / $17.89 / $71.59
| Professional | | $17.89 | $17.89 | $71.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.65 / $68.91 / $115.51
| Facility | | $62.65 | $68.91 | $115.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.11 / $40.28 / $40.28
| Professional | | $16.11 | $40.28 | $40.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.23 / $16.23 / $62.65
| Facility | | $16.23 | $16.23 | $62.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.89 / $17.89 / $23.14
| Professional | | $17.89 | $17.89 | $23.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.26 / $35.79 / $44.20
| Professional | | $11.26 | $35.79 | $44.20 |