- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $28.31 / $116.20
| Facility | | $0.02 | $28.31 | $116.20 |
- 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
- $9.61 / $9.61 / $9.61
| Professional | | $9.61 | $9.61 | $9.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.47 / $9.52 / $19.73
| Professional | | $5.47 | $9.52 | $19.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.27 / $13.80 / $13.80
| Facility | | $8.27 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $13.80 / $13.80
| Professional | | $1.78 | $13.80 | $13.80 |
- 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 / $25.09 / $115.39
| Professional | | $14.53 | $25.09 | $115.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $21.53
| Professional | | $5.05 | $5.05 | $21.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $5.05
| Facility | | $5.05 | $5.05 | $5.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $22.72 / $23.84
| Professional | | $5.05 | $22.72 | $23.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.24 / $4.24 / $4.24
| Professional | | $4.24 | $4.24 | $4.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $9.10 / $9.92
| Facility | | $5.50 | $9.10 | $9.92 |
- 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
- $22.66 / $22.66 / $33.31
| Professional | | $22.66 | $22.66 | $33.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.67 / $14.80 / $38.46
| Professional | | $9.67 | $14.80 | $38.46 |
- 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
- $20.19 / $23.35 / $27.34
| Professional | | $20.19 | $23.35 | $27.34 |