- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.03 / $48.75 / $286.33
| Facility | | $17.03 | $48.75 | $286.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.62 / $14.85 / $22.14
| Professional | | $13.62 | $14.85 | $22.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.45 / $15.56 / $51.09
| Facility | | $13.45 | $15.56 | $51.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.06 / $8.41 / $11.71
| Professional | | $8.06 | $8.41 | $11.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.03 / $18.73 / $23.84
| Facility | | $17.03 | $18.73 | $23.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.07 / $17.88 / $22.99
| Professional | | $11.07 | $17.88 | $22.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.46 / $17.03 / $43.61
| Facility | | $12.46 | $17.03 | $43.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.21 / $19.82 / $28.58
| Professional | | $11.21 | $19.82 | $28.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.03 / $17.03 / $17.03
| Facility | | $17.03 | $17.03 | $17.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $8.96 / $17.03
| Professional | | $7.15 | $8.96 | $17.03 |