- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $68.81 / $326.86
| Facility | | $0.02 | $68.81 | $326.86 |
- 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
- $10.92 / $10.92 / $10.92
| Professional | | $10.92 | $10.92 | $10.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.92 / $9.33 / $21.19
| Professional | | $7.92 | $9.33 | $21.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.89 / $19.80 / $19.80
| Facility | | $11.89 | $19.80 | $19.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.42 / $19.80 / $19.80
| Professional | | $9.42 | $19.80 | $19.80 |
- 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 / $24.47 / $115.39
| Professional | | $14.53 | $24.47 | $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
- $13.73 / $51.03 / $597.00
| Facility | | $13.73 | $51.03 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.17 / $16.17 / $25.30
| Professional | | $16.17 | $16.17 | $25.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.39 / $13.62 / $15.56
| Facility | | $12.39 | $13.62 | $15.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.67 / $15.56 / $38.74
| Professional | | $9.67 | $15.56 | $38.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.16 / $26.16 / $26.16
| Facility | | $26.16 | $26.16 | $26.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.61 / $23.35 / $27.34
| Professional | | $21.61 | $23.35 | $27.34 |