- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.65 / $85.75 / $173.05
| Facility | | $31.65 | $85.75 | $173.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.04 / $5.18 / $73.87
| Professional | | $4.04 | $5.18 | $73.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.44 / $10.44 / $10.44
| Facility | | $10.44 | $10.44 | $10.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $9.14 / $11.42
| Professional | | $5.78 | $9.14 | $11.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.30 / $83.74 / $118.73
| Facility | | $8.30 | $83.74 | $118.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.88 / $3.11 / $7.23
| Professional | | $2.88 | $3.11 | $7.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.69 / $10.55 / $16.23
| Facility | | $6.69 | $10.55 | $16.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.22 / $11.36 / $14.83
| Professional | | $6.22 | $11.36 | $14.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.78 / $12.10 / $14.23
| Professional | | $6.78 | $12.10 | $14.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $4.66 / $6.84
| Professional | | $2.18 | $4.66 | $6.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.18 / $5.18 / $5.18
| Professional | | $5.18 | $5.18 | $5.18 |