- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $64.57 / $154.88
| Facility | | $19.05 | $64.57 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $10.00 / $38.90
| Professional | | $7.08 | $10.00 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $18.62 / $63.10
| Facility | | $12.02 | $18.62 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $13.18 / $27.54
| Professional | | $7.94 | $13.18 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $32.36 / $51.29
| Facility | | $25.70 | $32.36 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $12.59 / $16.98
| Professional | | $12.59 | $12.59 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $16.98 / $26.30
| Facility | | $9.55 | $16.98 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $16.22 / $22.39
| Professional | | $9.12 | $16.22 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $3,630.78 / $9,772.37
| Facility | | $19.05 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $19.05 / $22.39
| Professional | | $19.05 | $19.05 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.18 / $13.18 / $39.81
| Professional | | $13.18 | $13.18 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.49 / $28.84 / $114.82
| Facility | | $15.49 | $28.84 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $18.62 / $63.10
| Facility | | $12.02 | $18.62 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $13.18 / $27.54
| Professional | | $7.94 | $13.18 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.59 / $13.18 / $21.88
| Facility | | $7.59 | $13.18 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.31 / $10.96 / $33.11
| Professional | | $6.31 | $10.96 | $33.11 |