- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $100.00 / $295.12
| Facility | | $10.00 | $100.00 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $20.89 / $89.13
| Professional | | $10.47 | $20.89 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $169.82 / $169.82 / $169.82
| Professional | 50 | $169.82 | $169.82 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $199.53 / $2,818.38
| Facility | | $25.70 | $199.53 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $26.30 / $66.07
| Professional | | $12.02 | $26.30 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.30 / $12.30 / $28.84
| Facility | | $12.30 | $12.30 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $23.44 / $40.74
| Professional | | $12.30 | $23.44 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $25.70 / $53.70
| Professional | | $12.02 | $25.70 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $83.18 / $7,079.46
| Facility | | $12.59 | $83.18 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $26.92 / $38.90
| Professional | | $21.88 | $26.92 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $23.44 / $50.12
| Professional | | $11.75 | $23.44 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $81.28 / $81.28
| Facility | | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $29.51 / $42.66
| Professional | | $13.80 | $29.51 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $144.54 / $2,818.38
| Facility | | $25.70 | $144.54 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $26.30 / $66.07
| Professional | | $12.02 | $26.30 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $1,819.70 / $2,818.38
| Facility | | $194.98 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $28.18 / $54.95
| Professional | | $13.49 | $28.18 | $54.95 |