- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.54 / $51.86 / $145.34
| Facility | | $19.54 | $51.86 | $145.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.57 / $19.54 / $25.16
| Professional | | $16.57 | $19.54 | $25.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.08 / $90.58 / $164.58
| Facility | | $31.08 | $90.58 | $164.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.60 / $29.60 / $29.60
| Professional | | $29.60 | $29.60 | $29.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.02 / $67.40 / $131.37
| Facility | | $21.02 | $67.40 | $131.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.69 / $36.34 / $43.53
| Professional | | $15.69 | $36.34 | $43.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $140.60 / $140.60
| Facility | | $50.00 | $140.60 | $140.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.00 / $148.00 / $222.00
| Professional | | $148.00 | $148.00 | $222.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.05 / $29.60 / $44.40
| Facility | | $18.05 | $29.60 | $44.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.12 / $29.60 / $37.00
| Professional | | $28.12 | $29.60 | $37.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.60 / $51.80 / $113.37
| Professional | | $29.60 | $51.80 | $113.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.11 / $32.18 / $107.19
| Facility | | $20.11 | $32.18 | $107.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.23 / $35.52 / $55.35
| Professional | | $19.23 | $35.52 | $55.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.43 / $13.81 / $19.73
| Professional | | $12.43 | $13.81 | $19.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.62 / $14.62 / $29.60
| Professional | | $14.62 | $14.62 | $29.60 |