- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.36 / $32.09 / $563.02
| Facility | | $15.36 | $32.09 | $563.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.36 / $20.38 / $24.60
| Professional | | $15.36 | $20.38 | $24.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.14 / $7.14 / $7.14
| Facility | | $7.14 | $7.14 | $7.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $9.36 / $12.38
| Professional | | $9.36 | $9.36 | $12.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.98 / $25.02 / $30.44
| Facility | | $21.98 | $25.02 | $30.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.55 / $25.02 / $111.22
| Professional | | $20.55 | $25.02 | $111.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.55 / $1.12 / $31.32
| Facility | | $0.55 | $1.12 | $31.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.47 / $18.30 / $47.51
| Professional | | $9.47 | $18.30 | $47.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.00 / $45.00 / $3,000.00
| Professional | | $45.00 | $45.00 | $3,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.98 / $12.73 / $21.20
| Professional | | $10.98 | $12.73 | $21.20 |