- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.81 / $69.06 / $117.36
| Facility | | $14.81 | $69.06 | $117.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.22 / $33.53 / $33.53
| Professional | | $9.22 | $33.53 | $33.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.67 / $27.67 / $27.67
| Facility | | $27.67 | $27.67 | $27.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.26 / $11.56 / $14.46
| Professional | | $7.26 | $11.56 | $14.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.83 / $10.83 / $10.83
| Facility | | $10.83 | $10.83 | $10.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.01 / $10.01 / $40.04
| Professional | | $10.01 | $10.01 | $40.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.04 / $38.54 / $64.56
| Facility | | $35.04 | $38.54 | $64.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.01 / $22.52 / $22.52
| Professional | | $9.01 | $22.52 | $22.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.83 / $10.83 / $35.04
| Facility | | $10.83 | $10.83 | $35.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.01 / $12.94 / $14.47
| Professional | | $10.01 | $12.94 | $14.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.30 / $20.02 / $30.20
| Professional | | $6.30 | $20.02 | $30.20 |