- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.60 / $141.16 / $368.28
| Facility | | $34.60 | $141.16 | $368.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.81 / $45.62 / $63.66
| Professional | | $22.81 | $45.62 | $63.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.48 / $9.48 / $35.09
| Professional | | $9.48 | $9.48 | $35.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.26 / $39.56 / $132.52
| Facility | | $28.26 | $39.56 | $132.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.27 / $35.31 / $69.98
| Professional | | $21.27 | $35.31 | $69.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.37 / $21.37 / $30.85
| Facility | | $21.37 | $21.37 | $30.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.05 / $21.05 / $41.28
| Professional | | $21.05 | $21.05 | $41.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.63 / $18.52 / $40.86
| Professional | | $4.63 | $18.52 | $40.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.64 / $52.64 / $52.64
| Facility | | $52.64 | $52.64 | $52.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.28 / $17.61 / $72.98
| Professional | | $12.28 | $17.61 | $72.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.05 / $21.05 / $21.05
| Professional | | $21.05 | $21.05 | $21.05 |