- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $61.66 / $87.10
| Facility | | $18.20 | $61.66 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $20.89 / $33.11
| Professional | | $16.98 | $20.89 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.95 / $30.90 / $128.82
| Facility | | $19.95 | $30.90 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $26.92 / $56.23
| Professional | | $12.59 | $26.92 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $33.88 / $53.70
| Facility | | $26.92 | $33.88 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $25.70 / $26.30
| Professional | | $25.70 | $25.70 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $19.95 / $43.65
| Facility | | $17.78 | $19.95 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $33.11 / $41.69
| Professional | | $15.14 | $33.11 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $38.90 / $45.71
| Professional | | $38.90 | $38.90 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $26.92 / $57.54
| Professional | | $26.92 | $26.92 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $85.11 / $426.58
| Facility | | $85.11 | $85.11 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.95 / $30.90 / $128.82
| Facility | | $19.95 | $30.90 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $26.92 / $56.23
| Professional | | $12.88 | $26.92 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.49 / $26.92 / $32.36
| Facility | | $13.49 | $26.92 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $16.22 / $58.88
| Professional | | $12.30 | $16.22 | $58.88 |