- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.39 / $58.41 / $89.84
| Facility | | $17.39 | $58.41 | $89.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.75 / $19.23 / $23.23
| Professional | | $16.75 | $19.23 | $23.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.35 / $140.69 / $8,639.91
| Facility | | $108.35 | $140.69 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.75 / $16.75 / $16.75
| Professional | | $16.75 | $16.75 | $16.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.11 / $28.60 / $71.72
| Facility | | $14.11 | $28.60 | $71.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.51 / $24.37 / $37.65
| Professional | | $13.51 | $24.37 | $37.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.88 / $17.18 / $29.08
| Professional | | $9.88 | $17.18 | $29.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.26 / $58.41 / $89.84
| Facility | | $18.26 | $58.41 | $89.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.11 / $20.62 / $88.71
| Professional | | $16.11 | $20.62 | $88.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.38 / $32.64 / $71.72
| Facility | | $14.38 | $32.64 | $71.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.51 / $24.37 / $37.65
| Professional | | $13.51 | $24.37 | $37.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.48 / $21.48 / $21.48
| Facility | | $21.48 | $21.48 | $21.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.89 / $21.48 / $30.58
| Professional | | $18.89 | $21.48 | $30.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $13.18 / $37.64
| Professional | | $9.02 | $13.18 | $37.64 |