- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.73 / $56.15 / $86.35
| Facility | | $16.73 | $56.15 | $86.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.11 / $16.93 / $85.28
| Professional | | $16.11 | $16.93 | $85.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.14 / $135.22 / $8,639.91
| Facility | | $104.14 | $135.22 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.11 / $16.11 / $16.11
| Professional | | $16.11 | $16.11 | $16.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.58 / $27.49 / $68.45
| Facility | | $13.58 | $27.49 | $68.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.89 / $23.95 / $36.39
| Professional | | $12.89 | $23.95 | $36.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.50 / $12.18 / $27.96
| Professional | | $9.50 | $12.18 | $27.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.55 / $56.15 / $86.35
| Facility | | $17.55 | $56.15 | $86.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.87 / $17.55 / $85.28
| Professional | | $14.87 | $17.55 | $85.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.82 / $31.37 / $68.45
| Facility | | $13.82 | $31.37 | $68.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.89 / $23.95 / $36.39
| Professional | | $12.89 | $23.95 | $36.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.65 / $20.65 / $20.65
| Facility | | $20.65 | $20.65 | $20.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.17 / $20.65 / $29.40
| Professional | | $18.17 | $20.65 | $29.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.28 / $12.80 / $36.18
| Professional | | $9.28 | $12.80 | $36.18 |