- 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
- $12.29 / $12.29 / $12.29
| Professional | | $12.29 | $12.29 | $12.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.64 / $10.23 / $22.05
| Professional | | $8.64 | $10.23 | $22.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.92 / $21.53 / $21.53
| Facility | | $12.92 | $21.53 | $21.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.72 / $21.53 / $21.53
| Professional | | $15.72 | $21.53 | $21.53 |
- 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 / $29.06 / $115.39
| Professional | | $14.53 | $29.06 | $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
- $14.20 / $14.20 / $73.39
| Facility | | $14.20 | $14.20 | $73.39 |
- 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
- $18.26 / $18.26 / $29.94
| Professional | | $18.26 | $18.26 | $29.94 |
- 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
- $22.22 / $26.16 / $26.16
| Facility | | $22.22 | $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 |