- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.41 / $130.03 / $436.85
| Facility | | $27.41 | $130.03 | $436.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.92 / $30.31 / $35.52
| Professional | | $24.92 | $30.31 | $35.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.82 / $28.10 / $41.92
| Facility | | $23.82 | $28.10 | $41.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.05 / $27.05 / $27.05
| Professional | | $27.05 | $27.05 | $27.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.99 / $21.53 / $150.28
| Facility | | $0.99 | $21.53 | $150.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.37 / $28.00 / $40.39
| Professional | | $18.37 | $28.00 | $40.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.97 / $16.97 / $170.00
| Facility | | $16.97 | $16.97 | $170.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.86 / $19.05 / $37.15
| Professional | | $12.86 | $19.05 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.66 / $149.16 / $244.11
| Facility | | $51.66 | $149.16 | $244.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.10 / $22.43 / $37.15
| Professional | | $13.10 | $22.43 | $37.15 |