- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.05 / $114.41 / $245.29
| Facility | | $20.05 | $114.41 | $245.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.22 / $16.67 / $21.24
| Professional | | $10.22 | $16.67 | $21.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.66 / $24.14 / $24.14
| Professional | | $9.66 | $24.14 | $24.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $17.38 / $20.29
| Facility | | $12.02 | $17.38 | $20.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.08 / $9.08 / $25.40
| Professional | | $9.08 | $9.08 | $25.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.30 / $23.17 / $27.23
| Facility | | $19.30 | $23.17 | $27.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.30 / $23.17 / $38.61
| Professional | | $19.30 | $23.17 | $38.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.55 / $14.73 / $33.36
| Facility | | $12.55 | $14.73 | $33.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.16 / $22.13 / $93.07
| Professional | | $10.16 | $22.13 | $93.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.62 / $10.62 / $10.62
| Professional | | $10.62 | $10.62 | $10.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $15.02 / $23.17
| Professional | | $8.11 | $15.02 | $23.17 |