- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.45 / $59.20 / $109.26
| Facility | | $21.45 | $59.20 | $109.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.30 / $21.45 / $38.53
| Professional | | $20.30 | $21.45 | $38.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.54 / $39.18 / $119.00
| Facility | | $20.54 | $39.18 | $119.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.51 / $22.52 / $54.85
| Professional | | $13.51 | $22.52 | $54.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.61 / $63.08 / $110.28
| Facility | | $39.61 | $63.08 | $110.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.17 / $21.17 / $28.80
| Professional | | $21.17 | $21.17 | $28.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.74 / $33.45 / $76.94
| Facility | | $15.74 | $33.45 | $76.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.53 / $24.89 / $37.97
| Professional | | $13.53 | $24.89 | $37.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.67 / $32.67 / $38.43
| Professional | | $32.67 | $32.67 | $38.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.52 / $31.21 / $83.82
| Professional | | $22.52 | $31.21 | $83.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.23 / $20.23 / $29.03
| Facility | | $20.23 | $20.23 | $29.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.18 / $119.00 / $119.00
| Facility | | $39.18 | $119.00 | $119.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.81 / $15.10 / $47.52
| Professional | | $10.81 | $15.10 | $47.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.81 / $15.10 / $42.92
| Professional | | $10.81 | $15.10 | $42.92 |