- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.14 / $65.56 / $87.42
| Facility | | $32.14 | $65.56 | $87.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.28 / $50.60 / $104.38
| Professional | | $32.28 | $50.60 | $104.38 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $80.54 / $105.59 / $108.41
| Professional | 25 | $80.54 | $105.59 | $108.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.39 / $55.67 / $81.18
| Facility | | $46.39 | $55.67 | $81.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.39 / $91.43 / $107.55
| Professional | | $46.39 | $91.43 | $107.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.54 / $56.54 / $56.54
| Facility | | $56.54 | $56.54 | $56.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $5.48 / $5.48 / $5.48
| Facility | AS | $5.48 | $5.48 | $5.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.61 / $60.08 / $142.38
| Professional | | $35.61 | $60.08 | $142.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.26 / $53.26 / $53.26
| Professional | | $53.26 | $53.26 | $53.26 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $48.28 / $48.28 / $48.28
| Professional | 25 | $48.28 | $48.28 | $48.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.37 / $39.10 / $65.15
| Professional | | $27.37 | $39.10 | $65.15 |