- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.32 / $43.87 / $2,345.23
| Facility | | $10.32 | $43.87 | $2,345.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.02 / $9.23 / $10.32
| Professional | | $6.02 | $9.23 | $10.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.09 / $36.65 / $71.47
| Facility | | $28.09 | $36.65 | $71.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.84 / $15.69 / $16.92
| Professional | | $7.84 | $15.69 | $16.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.00 / $33.00 / $33.00
| Facility | | $33.00 | $33.00 | $33.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.98 / $14.97 / $23.66
| Professional | | $11.98 | $14.97 | $23.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.19 / $20.44 / $231.44
| Facility | | $6.19 | $20.44 | $231.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.19 / $6.19 / $27.00
| Professional | | $6.19 | $6.19 | $27.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.65 / $21.04 / $32.35
| Facility | | $12.65 | $21.04 | $32.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.40 / $22.62 / $29.74
| Professional | | $12.40 | $22.62 | $29.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.63 / $6.19 / $20.64
| Professional | | $4.63 | $6.19 | $20.64 |