- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.33 / $270.23 / $768.40
| Facility | | $14.33 | $270.23 | $768.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.33 / $16.37 / $16.66
| Professional | | $14.33 | $16.37 | $16.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.14 / $140.31 / $280.51
| Facility | | $24.14 | $140.31 | $280.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $17.01 / $22.96
| Professional | | $15.00 | $17.01 | $22.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.38 / $53.25 / $146.76
| Facility | | $33.38 | $53.25 | $146.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $11.57 / $26.33
| Professional | | $9.36 | $11.57 | $26.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.23 / $16.53 / $34.31
| Facility | | $8.23 | $16.53 | $34.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.44 / $20.00 / $27.78
| Professional | | $8.44 | $20.00 | $27.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.10 / $10.10 / $14.55
| Professional | | $10.10 | $10.10 | $14.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.30 / $11.02 / $18.92
| Professional | | $4.30 | $11.02 | $18.92 |