- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.43 / $15.82 / $188.61
| Facility | | $5.43 | $15.82 | $188.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.36 / $11.30 / $21.19
| Professional | | $10.36 | $11.30 | $21.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.50 / $47.76 / $47.76
| Facility | | $37.50 | $47.76 | $47.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $10.60 / $10.60
| Professional | | $10.60 | $10.60 | $10.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.30 / $12.69 / $37.36
| Facility | | $8.30 | $12.69 | $37.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.65 / $12.83 / $20.65
| Professional | | $7.65 | $12.83 | $20.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.07 / $10.87 / $22.41
| Facility | | $7.07 | $10.87 | $22.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.23 / $15.74 / $21.00
| Professional | | $7.23 | $15.74 | $21.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $463.76 / $463.76 / $2,531.52
| Facility | | $463.76 | $463.76 | $2,531.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.07 / $8.11 / $16.01
| Professional | | $7.07 | $8.11 | $16.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.61 / $80.54 / $80.54
| Facility | | $34.61 | $80.54 | $80.54 |