- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.29 / $64.21 / $593.51
| Facility | | $20.29 | $64.21 | $593.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.48 / $24.63 / $137.72
| Professional | | $16.48 | $24.63 | $137.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.42 / $27.36 / $74.11
| Facility | | $21.42 | $27.36 | $74.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.13 / $16.13 / $28.83
| Professional | | $12.13 | $16.13 | $28.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.63 / $40.01 / $77.13
| Facility | | $20.63 | $40.01 | $77.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.23 / $24.67 / $48.20
| Professional | | $13.23 | $24.67 | $48.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.77 / $26.77 / $32.13
| Facility | | $26.77 | $26.77 | $32.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.85 / $20.22 / $42.84
| Professional | | $12.85 | $20.22 | $42.84 |