- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.52 / $47.51 / $140.29
| Facility | | $19.52 | $47.51 | $140.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.08 / $20.01 / $26.30
| Professional | | $14.08 | $20.01 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.36 / $82.41 / $142.06
| Facility | | $30.36 | $82.41 | $142.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $14.37 / $27.11
| Professional | | $5.00 | $14.37 | $27.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.11 / $27.11 / $27.11
| Facility | | $27.11 | $27.11 | $27.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.16 / $44.05 / $120.77
| Facility | | $17.16 | $44.05 | $120.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.26 / $20.54 / $41.30
| Professional | | $13.26 | $20.54 | $41.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.38 / $128.77 / $128.77
| Facility | | $43.38 | $128.77 | $128.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.18 / $27.11 / $29.82
| Facility | | $15.18 | $27.11 | $29.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.53 / $27.11 / $27.11
| Professional | | $23.53 | $27.11 | $27.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.21 / $27.11 / $38.67
| Facility | | $14.21 | $27.11 | $38.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.42 / $20.87 / $39.00
| Professional | | $12.42 | $20.87 | $39.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.76 / $11.39 / $27.11
| Facility | | $9.76 | $11.39 | $27.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.39 / $11.39 / $16.27
| Professional | | $11.39 | $11.39 | $16.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.57 / $10.84 / $27.11
| Professional | | $10.57 | $10.84 | $27.11 |