- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.39 / $40.83 / $182.52
| Facility | | $15.39 | $40.83 | $182.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.32 / $16.00 / $29.28
| Professional | | $14.32 | $16.00 | $29.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.43 / $12.43 / $12.43
| Professional | | $12.43 | $12.43 | $12.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.06 / $74.67 / $74.67
| Facility | | $40.06 | $74.67 | $74.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.74 / $11.64 / $16.73
| Professional | | $10.74 | $11.64 | $16.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.22 / $18.96 / $47.15
| Facility | | $12.22 | $18.96 | $47.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.31 / $13.13 / $25.81
| Professional | | $11.31 | $13.13 | $25.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.32 / $16.23 / $35.03
| Facility | | $14.32 | $16.23 | $35.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.19 / $25.65 / $33.00
| Professional | | $17.19 | $25.65 | $33.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.06 / $12.22 / $24.43
| Professional | | $8.06 | $12.22 | $24.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.09 / $146.00 / $146.00
| Facility | | $80.09 | $146.00 | $146.00 |