- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $27.54 / $79.43
| Facility | | $21.88 | $27.54 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $16.98 / $27.54
| Professional | | $12.02 | $16.98 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $46.77 / $63.10
| Facility | | $28.84 | $46.77 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $17.78 / $31.62
| Professional | | $11.75 | $17.78 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $38.02 / $45.71
| Professional | | $17.78 | $38.02 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $17.78 / $22.39
| Facility | | $17.78 | $17.78 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $21.88 / $35.48
| Professional | | $17.78 | $21.88 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $17.78 / $39.81
| Facility | | $17.78 | $17.78 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $25.70 / $60.26
| Facility | | $16.98 | $25.70 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $21.88 / $79.43
| Professional | | $17.78 | $21.88 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.30 / $52.48 / $72.44
| Facility | | $26.30 | $52.48 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.18 / $17.78 / $22.39
| Professional | | $13.18 | $17.78 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.38 / $21.38 / $28.18
| Facility | | $21.38 | $21.38 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $10.00 / $24.55
| Professional | | $7.41 | $10.00 | $24.55 |