- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.38 / $33.97 / $147.60
| Facility | | $10.38 | $33.97 | $147.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.36 / $8.23 / $10.86
| Professional | | $7.36 | $8.23 | $10.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.66 / $5.66 / $5.66
| Professional | | $5.66 | $5.66 | $5.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.82 / $12.06 / $31.00
| Facility | | $6.82 | $12.06 | $31.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.49 / $4.66 / $19.28
| Professional | | $3.49 | $4.66 | $19.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.14 / $9.44 / $15.10
| Facility | | $6.14 | $9.44 | $15.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.14 / $6.14 / $9.44
| Professional | | $6.14 | $6.14 | $9.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.35 / $20.77 / $29.41
| Facility | | $9.35 | $20.77 | $29.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.14 / $11.56 / $14.45
| Professional | | $6.14 | $11.56 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.32 / $12.27 / $33.89
| Professional | | $10.32 | $12.27 | $33.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,663.61 / $1,725.03 / $2,164.00
| Facility | | $1,663.61 | $1,725.03 | $2,164.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.54 / $6.89 / $16.52
| Professional | | $5.54 | $6.89 | $16.52 |