- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.06 / $64.17 / $340.17
| Facility | | $35.06 | $64.17 | $340.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.55 / $20.39 / $22.30
| Professional | | $17.55 | $20.39 | $22.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.23 / $26.35 / $29.14
| Facility | | $25.23 | $26.35 | $29.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.42 / $21.42 / $40.53
| Professional | | $21.42 | $21.42 | $40.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.13 / $51.13 / $89.88
| Facility | | $51.13 | $51.13 | $89.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.57 / $31.61 / $71.14
| Professional | | $15.57 | $31.61 | $71.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.07 / $28.68 / $43.65
| Professional | | $14.07 | $28.68 | $43.65 |