- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.13 / $60.68 / $144.05
| Facility | | $42.13 | $60.68 | $144.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.13 / $42.13 / $42.13
| Professional | | $42.13 | $42.13 | $42.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.70 / $15.20 / $34.40
| Facility | | $5.70 | $15.20 | $34.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.66 / $112.39 / $196.93
| Facility | | $55.66 | $112.39 | $196.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.13 / $42.13 / $42.13
| Facility | | $42.13 | $42.13 | $42.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.11 / $60.13 / $90.00
| Facility | | $19.11 | $60.13 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $51.43 / $51.43
| Professional | | $3.50 | $51.43 | $51.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.43 / $51.43 / $51.43
| Professional | | $51.43 | $51.43 | $51.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.57 / $30.98 / $48.33
| Professional | | $20.57 | $30.98 | $48.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.80 / $30.86 / $51.43
| Professional | | $28.80 | $30.86 | $51.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.40 / $2.00 / $5.00
| Professional | | $1.40 | $2.00 | $5.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.32 / $59.51 / $141.71
| Facility | | $35.32 | $59.51 | $141.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.13 / $59.10 / $73.88
| Professional | | $42.13 | $59.10 | $73.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.92 / $37.92 / $37.92
| Facility | | $37.92 | $37.92 | $37.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.73 / $23.14 / $51.43
| Professional | | $17.73 | $23.14 | $51.43 |