- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $102.33 / $218.78
| Facility | | $29.51 | $102.33 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $12.88 / $64.57
| Professional | | $12.02 | $12.88 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $85.11 / $186.21
| Professional | | $47.86 | $85.11 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.54 / $28.18 / $63.10
| Facility | | $27.54 | $28.18 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $19.50 / $23.99
| Professional | | $9.12 | $19.50 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.88
| Professional | | $32.36 | $32.36 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $20.42 / $20.42
| Facility | | $20.42 | $20.42 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $10.72 / $28.84
| Professional | | $7.08 | $10.72 | $28.84 |