- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.48 / $6.48 / $93.08
| Professional | | $6.48 | $6.48 | $93.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.06 / $55.99 / $58.19
| Facility | | $24.06 | $55.99 | $58.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $22.91
| Professional | | $22.91 | $22.91 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.47 / $69.50 / $106.61
| Facility | | $59.47 | $69.50 | $106.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.26 / $64.30 / $73.06
| Professional | | $27.26 | $64.30 | $73.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.47 / $16.47 / $29.32
| Facility | | $16.47 | $16.47 | $29.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.47 / $16.47 / $112.04
| Facility | | $16.47 | $16.47 | $112.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.16 / $19.34 / $53.45
| Professional | | $13.16 | $19.34 | $53.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.00 / $65.00 / $3,000.00
| Professional | | $55.00 | $65.00 | $3,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.47 / $16.47 / $29.32
| Facility | | $16.47 | $16.47 | $29.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.32 / $56.98 / $80.05
| Professional | | $32.32 | $56.98 | $80.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.88 / $50.00 / $112.04
| Facility | | $45.88 | $50.00 | $112.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.11 / $16.11 / $16.11
| Professional | | $16.11 | $16.11 | $16.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.11 / $16.11 / $16.11
| Professional | | $16.11 | $16.11 | $16.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.97 / $18.36 / $53.45
| Professional | | $11.97 | $18.36 | $53.45 |