- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $107.15 / $354.81
| Facility | | $52.48 | $107.15 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $7.59 / $12.02
| Professional | | $5.01 | $7.59 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.41 / $7.59 / $23.99
| Facility | | $7.41 | $7.59 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $10.00 / $16.60
| Professional | | $5.50 | $10.00 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.71 / $31.62 / $45.71
| Facility | | $8.71 | $31.62 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.89 / $7.41 / $7.76
| Professional | | $5.89 | $7.41 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $8.71 / $27.54
| Professional | | $6.03 | $8.71 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $8.71 / $16.60
| Professional | | $7.59 | $8.71 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.95 / $4.37 / $44.67
| Facility | | $2.95 | $4.37 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.63 / $5.13 / $12.02
| Professional | | $3.63 | $5.13 | $12.02 |