- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.61 / $53.76 / $107.52
| Facility | | $19.61 | $53.76 | $107.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.05 / $12.35 / $88.16
| Professional | | $9.05 | $12.35 | $88.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $39.40 / $76.83
| Facility | | $30.20 | $39.40 | $76.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.42 / $20.84 / $22.48
| Professional | | $10.42 | $20.84 | $22.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $55.00
| Facility | | $55.00 | $55.00 | $55.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.69 / $19.62 / $31.01
| Professional | | $15.69 | $19.62 | $31.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.23 / $39.20 / $111.36
| Facility | | $8.23 | $39.20 | $111.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.86 / $8.23 / $26.36
| Professional | | $5.86 | $8.23 | $26.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.45 / $20.03 / $37.69
| Facility | | $16.45 | $20.03 | $37.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.23 / $27.51 / $35.78
| Professional | | $15.23 | $27.51 | $35.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.86 / $8.23 / $26.36
| Professional | | $5.86 | $8.23 | $26.36 |