- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.26 / $38.08 / $94.72
| Facility | | $4.26 | $38.08 | $94.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.30 / $3.84 / $7.60
| Professional | | $3.30 | $3.84 | $7.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $2.14 / $2.56
| Professional | | $2.14 | $2.14 | $2.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.08 / $4.72 / $13.01
| Facility | | $3.08 | $4.72 | $13.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $2.11 / $6.15
| Professional | | $1.58 | $2.11 | $6.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.78 / $4.26 / $6.83
| Facility | | $2.78 | $4.26 | $6.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.78 / $2.78 / $4.26
| Professional | | $2.78 | $2.78 | $4.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.19 / $9.39 / $13.58
| Facility | | $4.19 | $9.39 | $13.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.78 / $5.37 / $6.71
| Professional | | $2.78 | $5.37 | $6.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.67 / $5.55 / $8.44
| Professional | | $4.67 | $5.55 | $8.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,123.17 / $2,680.48 / $2,932.00
| Facility | | $2,123.17 | $2,680.48 | $2,932.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.84 / $3.84 / $5.28
| Facility | | $3.84 | $3.84 | $5.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $2.56 / $7.47
| Professional | | $1.60 | $2.56 | $7.47 |