- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.72 / $62.69 / $224.89
| Facility | | $37.72 | $62.69 | $224.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.43 / $33.95 / $35.84
| Professional | | $29.43 | $33.95 | $35.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.64 / $22.64 / $22.64
| Professional | | $22.64 | $22.64 | $22.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.80 / $37.72 / $47.16
| Facility | | $16.80 | $37.72 | $47.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.63 / $22.82 / $28.97
| Professional | | $18.63 | $22.82 | $28.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.52 / $44.14 / $136.58
| Facility | | $24.52 | $44.14 | $136.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.27 / $43.37 / $54.21
| Professional | | $28.27 | $43.37 | $54.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.40 / $37.72 / $39.61
| Professional | | $0.40 | $37.72 | $39.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.96 / $12.96 / $12.96
| Professional | | $12.96 | $12.96 | $12.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $30.00 / $52.70
| Professional | | $15.85 | $30.00 | $52.70 |