- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.06 / $192.90
| Facility | | $0.02 | $0.06 | $192.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.65 / $192.90 / $192.90
| Professional | | $46.65 | $192.90 | $192.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.86 / $72.36 / $312.00
| Facility | | $32.86 | $72.36 | $312.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.49 / $12.00 / $32.54
| Professional | | $9.49 | $12.00 | $32.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.38 / $77.78 / $156.61
| Facility | | $34.38 | $77.78 | $156.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.47 / $10.67 / $37.13
| Professional | | $7.47 | $10.67 | $37.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.70 / $38.82 / $96.72
| Facility | | $13.70 | $38.82 | $96.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $32.04 / $45.95
| Professional | | $8.91 | $32.04 | $45.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $33.00 / $99.00
| Professional | | $30.00 | $33.00 | $99.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.00 / $30.00 / $58.50
| Professional | | $24.00 | $30.00 | $58.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $142.50 / $142.50
| Facility | | $55.00 | $142.50 | $142.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.00 / $18.00 / $18.00
| Professional | | $18.00 | $18.00 | $18.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.00 / $27.89 / $66.90
| Facility | | $15.00 | $27.89 | $66.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.03 / $18.00 / $36.00
| Professional | | $9.03 | $18.00 | $36.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.30 / $105.30 / $105.30
| Professional | | $105.30 | $105.30 | $105.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.07 / $12.60 / $36.00
| Professional | | $7.07 | $12.60 | $36.00 |