- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.42 / $96.61 / $381.50
| Facility | | $14.42 | $96.61 | $381.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.24 / $12.25 / $23.44
| Professional | | $8.24 | $12.25 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.59 / $8.24 / $13.73
| Professional | | $6.59 | $8.24 | $13.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.34 / $43.80 / $82.24
| Facility | | $16.34 | $43.80 | $82.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $7.55 / $9.61
| Professional | | $5.00 | $7.55 | $9.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.73 / $21.97 / $96.26
| Facility | | $13.73 | $21.97 | $96.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.61 / $13.73 / $23.35
| Professional | | $9.61 | $13.73 | $23.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.46 / $13.46 / $13.73
| Facility | | $13.46 | $13.46 | $13.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.60 / $30.15 / $68.75
| Facility | | $9.60 | $30.15 | $68.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.28 / $10.11 / $22.98
| Professional | | $7.28 | $10.11 | $22.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.51 / $96.00 / $96.00
| Facility | | $73.51 | $96.00 | $96.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.25 / $8.25 / $8.25
| Professional | | $8.25 | $8.25 | $8.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.98 / $13.73 / $21.37
| Facility | | $10.98 | $13.73 | $21.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.36 / $13.73 / $17.89
| Professional | | $12.36 | $13.73 | $17.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.31 / $114.97 / $309.27
| Facility | | $85.31 | $114.97 | $309.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.98 / $13.73 / $34.10
| Facility | | $10.98 | $13.73 | $34.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.28 / $10.57 / $19.67
| Professional | | $7.28 | $10.57 | $19.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.77 / $7.91 / $13.73
| Professional | | $5.77 | $7.91 | $13.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.35 / $6.78 / $13.73
| Professional | | $5.35 | $6.78 | $13.73 |