- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $19.66 / $98.69
| Facility | | $0.02 | $19.66 | $98.69 |
- 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 / $12.29
| Professional | | $9.61 | $9.61 | $12.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.31 / $6.66 / $17.59
| Professional | | $3.31 | $6.66 | $17.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.95 / $8.25 / $8.25
| Facility | | $4.95 | $8.25 | $8.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.09 / $8.25 / $8.25
| Professional | | $5.09 | $8.25 | $8.25 |
- 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
- $14.04 / $22.98 / $115.39
| Professional | | $14.04 | $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
- $17.55 / $23.26 / $34.19
| Professional | | $17.55 | $23.26 | $34.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.67 / $14.56 / $38.74
| Professional | | $9.67 | $14.56 | $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 |