- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.67 / $15.67 / $62.41
| Facility | | $15.67 | $15.67 | $62.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.48 / $15.67 / $16.93
| Professional | | $15.48 | $15.67 | $16.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.59 / $87.45 / $87.45
| Facility | | $53.59 | $87.45 | $87.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.69 / $17.63 / $27.34
| Professional | | $14.69 | $17.63 | $27.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.59 / $22.19 / $51.60
| Facility | | $13.59 | $22.19 | $51.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.31 / $15.50 / $28.39
| Professional | | $13.31 | $15.50 | $28.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.38 / $15.28 / $41.02
| Facility | | $10.38 | $15.28 | $41.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.56 / $30.03 / $72.09
| Professional | | $28.56 | $30.03 | $72.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.80 / $14.31 / $28.61
| Professional | | $9.80 | $14.31 | $28.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.74 / $580.84 / $596.54
| Facility | | $88.74 | $580.84 | $596.54 |