- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.61 / $90.65 / $771.75
| Facility | | $23.61 | $90.65 | $771.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $69.75 / $177.45
| Professional | | $9.02 | $69.75 | $177.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.87 / $2.87 / $2.87
| Professional | | $2.87 | $2.87 | $2.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.49 / $33.09 / $70.84
| Facility | | $11.49 | $33.09 | $70.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.22 / $11.00 / $14.28
| Professional | | $5.22 | $11.00 | $14.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.77 / $15.12 / $31.61
| Facility | | $2.77 | $15.12 | $31.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $3.27 / $7.23
| Professional | | $2.63 | $3.27 | $7.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.07 / $6.02 / $10.22
| Facility | | $4.07 | $6.02 | $10.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $7.47 / $10.00
| Professional | | $6.00 | $7.47 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.87 / $2.87 / $4.13
| Professional | | $2.87 | $2.87 | $4.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $3.55 / $7.30
| Professional | | $2.19 | $3.55 | $7.30 |