- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.00 / $50.50 / $170.59
| Facility | | $9.00 | $50.50 | $170.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.09 / $15.66 / $21.10
| Professional | | $13.09 | $15.66 | $21.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.58 / $10.58 / $10.58
| Professional | | $10.58 | $10.58 | $10.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.32 / $42.52 / $293.00
| Facility | | $19.32 | $42.52 | $293.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $13.89 / $45.25
| Professional | | $8.71 | $13.89 | $45.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.60 / $87.40 / $226.69
| Facility | | $44.60 | $87.40 | $226.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.93 / $15.61 / $60.96
| Professional | | $10.93 | $15.61 | $60.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.21 / $23.15 / $59.02
| Facility | | $12.21 | $23.15 | $59.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.46 / $21.37 / $31.32
| Professional | | $11.46 | $21.37 | $31.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.68 / $17.63 / $28.21
| Professional | | $15.68 | $17.63 | $28.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.10 / $17.63 / $38.79
| Professional | | $14.10 | $17.63 | $38.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.00 / $84.00 / $100.00
| Facility | | $71.00 | $84.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.58 / $10.58 / $10.58
| Professional | | $10.58 | $10.58 | $10.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.59 / $20.60 / $52.85
| Facility | | $14.59 | $20.60 | $52.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.83 / $17.63 / $35.26
| Professional | | $11.83 | $17.63 | $35.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.88 / $61.88 / $61.88
| Professional | | $61.88 | $61.88 | $61.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.10 / $17.63 / $24.68
| Professional | | $14.10 | $17.63 | $24.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.40 / $10.58 / $35.47
| Professional | | $7.40 | $10.58 | $35.47 |