- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.14 / $494.87 / $996.05
| Facility | | $17.14 | $494.87 | $996.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.05 / $9.36 / $18.73
| Professional | | $8.05 | $9.36 | $18.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.19 / $6.19 / $6.19
| Professional | | $6.19 | $6.19 | $6.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.59 / $10.32 / $12.90
| Facility | | $4.59 | $10.32 | $12.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.09 / $6.24 / $7.92
| Professional | | $5.09 | $6.24 | $7.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.71 / $12.08 / $37.36
| Facility | | $6.71 | $12.08 | $37.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.74 / $11.98 / $14.97
| Professional | | $7.74 | $11.98 | $14.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.10 / $10.32 / $10.84
| Professional | | $0.10 | $10.32 | $10.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $3.55 / $3.55
| Professional | | $3.55 | $3.55 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.48 / $15.48 / $15.48
| Facility | | $15.48 | $15.48 | $15.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.33 / $6.06 / $10.50
| Professional | | $4.33 | $6.06 | $10.50 |