- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.19 / $45.97 / $118.36
| Facility | | $20.19 | $45.97 | $118.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.38 / $19.73 / $21.48
| Professional | | $11.38 | $19.73 | $21.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.55 / $49.40 / $138.00
| Facility | | $22.55 | $49.40 | $138.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.61 / $19.32 / $37.04
| Professional | | $10.61 | $19.32 | $37.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.87 / $38.96 / $62.82
| Facility | | $14.87 | $38.96 | $62.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.98 / $27.73 / $42.85
| Professional | | $14.98 | $27.73 | $42.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.29 / $20.72 / $22.79
| Professional | | $15.29 | $20.72 | $22.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.48 / $22.55 / $51.25
| Facility | | $21.48 | $22.55 | $51.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.48 / $32.22 / $59.07
| Facility | | $21.48 | $32.22 | $59.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.32 / $19.32 / $19.32
| Professional | | $19.32 | $19.32 | $19.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.70 / $35.44 / $59.07
| Facility | | $24.70 | $35.44 | $59.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.11 / $21.48 / $58.38
| Professional | | $16.11 | $21.48 | $58.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.96 / $20.41 / $21.48
| Facility | | $13.96 | $20.41 | $21.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $9.02 / $21.48
| Professional | | $9.02 | $9.02 | $21.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.67 / $9.67 / $11.13
| Professional | | $9.67 | $9.67 | $11.13 |