- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $28.31 / $93.00
| Facility | | $0.02 | $28.31 | $93.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.04 / $19.66 / $19.66
| Professional | | $18.04 | $19.66 | $19.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.93 / $12.43 / $29.25
| Professional | | $8.93 | $12.43 | $29.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.31 / $22.18 / $22.18
| Facility | | $13.31 | $22.18 | $22.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.94 / $22.18 / $22.18
| Professional | | $11.94 | $22.18 | $22.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $51.03 / $84.04
| Facility | | $50.00 | $51.03 | $84.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.53 / $29.06 / $115.39
| Professional | | $14.53 | $29.06 | $115.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.53 / $21.53 / $21.53
| Professional | | $21.53 | $21.53 | $21.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.58 / $23.35 / $25.72
| Professional | | $21.58 | $23.35 | $25.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.74 / $37.74 / $37.74
| Facility | | $37.74 | $37.74 | $37.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.73 / $51.03 / $597.00
| Facility | | $13.73 | $51.03 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.47 / $37.26 / $54.77
| Professional | | $24.47 | $37.26 | $54.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.67 / $17.23 / $37.13
| Professional | | $9.67 | $17.23 | $37.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.64 / $26.16 / $26.16
| Facility | | $15.64 | $26.16 | $26.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.19 / $23.35 / $27.34
| Professional | | $20.19 | $23.35 | $27.34 |