- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.09 / $311.94 / $916.81
| Facility | | $45.09 | $311.94 | $916.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.55 / $8.24 / $10.56
| Professional | | $6.55 | $8.24 | $10.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.70 / $7.04 / $10.56
| Professional | | $3.70 | $7.04 | $10.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.40 / $32.95 / $62.30
| Facility | | $11.40 | $32.95 | $62.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $5.60 / $7.53
| Professional | | $5.00 | $5.60 | $7.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.50 / $15.84 / $310.39
| Facility | | $9.50 | $15.84 | $310.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.92 / $11.20 / $17.95
| Professional | | $7.92 | $11.20 | $17.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.56 / $10.56 / $10.56
| Facility | | $10.56 | $10.56 | $10.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.38 / $23.05 / $48.60
| Facility | | $7.38 | $23.05 | $48.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.07 / $10.54 / $18.64
| Professional | | $6.07 | $10.54 | $18.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.15 / $91.74 / $100.00
| Facility | | $72.15 | $91.74 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.50 / $13.62 / $18.67
| Professional | | $9.50 | $13.62 | $18.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.44 / $15.91 / $657.60
| Facility | | $8.44 | $15.91 | $657.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.00 / $10.56 / $19.54
| Professional | | $9.00 | $10.56 | $19.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.23 / $10.56 / $26.59
| Facility | | $8.23 | $10.56 | $26.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.60 / $10.54 / $17.66
| Professional | | $5.60 | $10.54 | $17.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.44 / $6.10 / $8.61
| Professional | | $4.44 | $6.10 | $8.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.22 / $5.22 / $10.56
| Professional | | $5.22 | $5.22 | $10.56 |