- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.18 / $38.90 / $89.13
| Facility | | $13.18 | $38.90 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $12.02 / $58.88
| Professional | | $8.91 | $12.02 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $18.62 / $67.61
| Facility | | $12.02 | $18.62 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $13.18 / $28.18
| Professional | | $7.94 | $13.18 | $28.18 |
- 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
- $10.23 / $20.89 / $51.29
| Facility | | $10.23 | $20.89 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $16.22 / $22.39
| Professional | | $9.77 | $16.22 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.91 / $3,630.78 / $9,772.37
| Facility | | $22.91 | $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
- $12.59 / $17.38 / $77.62
| Facility | | $12.59 | $17.38 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $18.62 / $67.61
| Facility | | $12.02 | $18.62 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $13.18 / $28.18
| Professional | | $7.94 | $13.18 | $28.18 |
- 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
- $6.61 / $11.48 / $31.62
| Professional | | $6.61 | $11.48 | $31.62 |