- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.41 / $82.22 / $257.79
| Facility | | $10.41 | $82.22 | $257.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.41 / $11.70 / $23.60
| Professional | | $10.41 | $11.70 | $23.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.67 / $9.02 / $9.02
| Professional | | $8.67 | $9.02 | $9.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.04 / $27.14 / $44.70
| Facility | | $22.04 | $27.14 | $44.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.81 / $9.11 / $21.19
| Professional | | $7.81 | $9.11 | $21.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.88 / $13.77 / $33.81
| Facility | | $8.88 | $13.77 | $33.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $9.66 / $18.59
| Professional | | $8.32 | $9.66 | $18.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.41 / $11.79 / $25.44
| Facility | | $10.41 | $11.79 | $25.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.48 / $17.88 / $24.00
| Professional | | $5.48 | $17.88 | $24.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.85 / $9.08 / $17.75
| Professional | | $5.85 | $9.08 | $17.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.83 / $108.48 / $108.48
| Facility | | $39.83 | $108.48 | $108.48 |