- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $13.88 / $68.81
| Facility | | $0.02 | $13.88 | $68.81 |
- 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
- $12.29 / $12.29 / $12.29
| Professional | | $12.29 | $12.29 | $12.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.90 / $7.66 / $18.39
| Professional | | $4.90 | $7.66 | $18.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.38 / $12.30 / $12.30
| Facility | | $7.38 | $12.30 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.09 / $12.30 / $12.30
| Professional | | $5.09 | $12.30 | $12.30 |
- 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
- $11.98 / $22.98 / $115.39
| Professional | | $11.98 | $22.98 | $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
- $23.44 / $23.44 / $23.44
| Facility | | $23.44 | $23.44 | $23.44 |
- 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
- $14.97 / $16.89 / $24.83
| Professional | | $14.97 | $16.89 | $24.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.67 / $15.19 / $38.46
| Professional | | $9.67 | $15.19 | $38.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.22 / $26.16 / $26.16
| Facility | | $23.22 | $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 |