- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.23 / $32.60 / $53.10
| Facility | | $15.23 | $32.60 | $53.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.15 / $10.15 / $15.84
| Professional | | $10.15 | $10.15 | $15.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.11 / $27.94
| Professional | | $2.11 | $2.11 | $27.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.63 / $18.63 / $18.63
| Facility | | $18.63 | $18.63 | $18.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.60 / $18.63 / $18.63
| Professional | | $13.60 | $18.63 | $18.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.02 / $37.46 / $48.00
| Facility | | $13.02 | $37.46 | $48.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.48 / $26.85 / $89.80
| Professional | | $21.48 | $26.85 | $89.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.63 / $34.09 / $332.00
| Facility | | $18.63 | $34.09 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.45 / $11.08 / $34.84
| Professional | | $7.45 | $11.08 | $34.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.67 / $17.70 / $20.92
| Professional | | $11.67 | $17.70 | $20.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.17 / $45.13 / $65.09
| Facility | | $18.17 | $45.13 | $65.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.11 / $18.63 / $38.38
| Professional | | $12.11 | $18.63 | $38.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.11 / $12.11 / $12.11
| Facility | | $12.11 | $12.11 | $12.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.82 / $10.48 / $27.01
| Professional | | $7.82 | $10.48 | $27.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.63 / $21.42 / $21.42
| Facility | | $18.63 | $21.42 | $21.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.67 / $17.70 / $22.39
| Professional | | $11.67 | $17.70 | $22.39 |