- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.46 / $67.56 / $210.21
| Facility | | $25.46 | $67.56 | $210.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.40 / $27.68 / $44.36
| Professional | | $21.40 | $27.68 | $44.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.51 / $18.51 / $23.14
| Professional | | $18.51 | $18.51 | $23.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.43 / $110.70 / $202.11
| Facility | | $42.43 | $110.70 | $202.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $20.44 / $38.57
| Professional | | $5.00 | $20.44 | $38.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.57 / $40.50 / $40.50
| Facility | | $38.57 | $40.50 | $40.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.05 / $76.70 / $170.99
| Facility | | $25.05 | $76.70 | $170.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.44 / $44.19 / $58.85
| Professional | | $20.44 | $44.19 | $58.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.71 / $183.21 / $183.21
| Facility | | $61.71 | $183.21 | $183.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.09 / $38.57 / $42.43
| Facility | | $28.09 | $38.57 | $42.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.12 / $38.57 / $38.57
| Professional | | $26.12 | $38.57 | $38.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.00 / $38.57 / $67.50
| Facility | | $27.00 | $38.57 | $67.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.44 / $34.71 / $56.00
| Professional | | $20.44 | $34.71 | $56.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.20 / $16.20 / $23.14
| Professional | | $16.20 | $16.20 | $23.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.04 / $15.43 / $38.57
| Professional | | $15.04 | $15.43 | $38.57 |