- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.54 / $41.26 / $189.46
| Facility | | $13.54 | $41.26 | $189.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.35 / $12.91 / $18.59
| Professional | | $11.35 | $12.91 | $18.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.35 / $26.11 / $108.80
| Facility | | $12.35 | $26.11 | $108.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $13.54 / $32.97
| Professional | | $8.11 | $13.54 | $32.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.66 / $37.68 / $65.88
| Facility | | $23.66 | $37.68 | $65.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.73 / $12.73 / $17.32
| Professional | | $12.73 | $12.73 | $17.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.46 / $20.12 / $46.31
| Facility | | $9.46 | $20.12 | $46.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $14.98 / $23.05
| Professional | | $8.11 | $14.98 | $23.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.52 / $3,472.00 / $9,239.00
| Facility | | $49.52 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.60 / $19.60 / $23.06
| Professional | | $19.60 | $19.60 | $23.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.54 / $18.77 / $50.42
| Professional | | $13.54 | $18.77 | $50.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.48 / $16.98 / $87.22
| Facility | | $14.48 | $16.98 | $87.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.11 / $108.80 / $108.80
| Facility | | $26.11 | $108.80 | $108.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $9.09 / $28.59
| Professional | | $6.50 | $9.09 | $28.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.54 / $15.93 / $22.07
| Facility | | $13.54 | $15.93 | $22.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $9.09 / $25.81
| Professional | | $6.50 | $9.09 | $25.81 |