- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.22 / $72.04 / $844.48
| Facility | | $5.22 | $72.04 | $844.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.88 / $69.92 / $177.45
| Professional | | $8.88 | $69.92 | $177.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.12 / $5.22 / $15.66
| Facility | | $4.12 | $5.22 | $15.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.70 / $2.96 / $5.22
| Professional | | $2.70 | $2.96 | $5.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.22 / $5.74 / $7.31
| Facility | | $5.22 | $5.74 | $7.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $5.48 / $7.05
| Professional | | $3.39 | $5.48 | $7.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.82 / $5.22 / $13.41
| Facility | | $3.82 | $5.22 | $13.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.44 / $5.78 / $13.14
| Professional | | $3.44 | $5.78 | $13.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.43 / $16.43 / $16.43
| Facility | | $16.43 | $16.43 | $16.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $3.39 / $5.74
| Professional | | $2.19 | $3.39 | $5.74 |