- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.22 / $64.80 / $112.12
| Facility | | $14.22 | $64.80 | $112.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.46 / $12.04 / $21.40
| Professional | | $10.46 | $12.04 | $21.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.92 / $9.92 / $10.33
| Professional | | $9.92 | $9.92 | $10.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.01 / $34.49 / $39.33
| Facility | | $28.01 | $34.49 | $39.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.40 / $17.32 / $17.32
| Professional | | $12.40 | $17.32 | $17.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.30 / $13.65 / $43.59
| Facility | | $8.30 | $13.65 | $43.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.65 / $13.08 / $26.82
| Professional | | $7.65 | $13.08 | $26.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.94 / $12.40 / $22.41
| Facility | | $9.94 | $12.40 | $22.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $16.41 / $21.00
| Professional | | $9.44 | $16.41 | $21.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,826.61 / $1,826.61 / $8,207.21
| Facility | | $1,826.61 | $1,826.61 | $8,207.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.84 / $19.84 / $19.84
| Facility | | $19.84 | $19.84 | $19.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.92 / $11.57 / $16.80
| Professional | | $9.92 | $11.57 | $16.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.50 / $78.52 / $78.52
| Facility | | $40.50 | $78.52 | $78.52 |