- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.02 / $144.71 / $436.32
| Facility | | $63.02 | $144.71 | $436.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.84 / $50.42 / $57.70
| Professional | | $13.84 | $50.42 | $57.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.57 / $41.57 / $41.57
| Facility | | $41.57 | $41.57 | $41.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.07 / $17.35 / $21.68
| Professional | | $11.07 | $17.35 | $21.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.13 / $13.13 / $13.13
| Facility | | $13.13 | $13.13 | $13.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.05 / $15.05 / $60.20
| Professional | | $15.05 | $15.05 | $60.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.68 / $57.94 / $97.12
| Facility | | $52.68 | $57.94 | $97.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.55 / $33.86 / $33.86
| Professional | | $13.55 | $33.86 | $33.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.13 / $13.13 / $52.68
| Facility | | $13.13 | $13.13 | $52.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.05 / $15.06 / $21.76
| Professional | | $15.05 | $15.06 | $21.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.46 / $30.10 / $45.41
| Professional | | $9.46 | $30.10 | $45.41 |