- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.78 / $68.81 / $206.46
| Facility | | $28.78 | $68.81 | $206.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.14 / $56.43 / $83.18
| Professional | | $22.14 | $56.43 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.27 / $15.27 / $17.68
| Professional | | $15.27 | $15.27 | $17.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.15 / $37.97 / $56.63
| Facility | | $32.15 | $37.97 | $56.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.69 / $34.56 / $34.56
| Professional | | $31.69 | $34.56 | $34.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.72 / $32.70 / $141.52
| Facility | | $16.72 | $32.70 | $141.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.66 / $36.65 / $53.00
| Professional | | $15.66 | $36.65 | $53.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.91 / $23.07 / $50.45
| Facility | | $22.91 | $23.07 | $50.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.69 / $16.87 / $51.92
| Professional | | $10.69 | $16.87 | $51.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.69 / $15.27 / $40.72
| Professional | | $10.69 | $15.27 | $40.72 |