- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.96 / $56.94 / $87.56
| Facility | | $16.96 | $56.94 | $87.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.54 / $16.96 / $107.00
| Professional | | $16.54 | $16.96 | $107.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.70 / $65.84 / $8,639.91
| Facility | | $50.70 | $65.84 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.32 / $16.32 / $16.32
| Professional | | $16.32 | $16.32 | $16.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.76 / $27.22 / $69.54
| Facility | | $13.76 | $27.22 | $69.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.80 / $23.72 / $33.01
| Professional | | $11.80 | $23.72 | $33.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.63 / $16.75 / $28.35
| Professional | | $9.63 | $16.75 | $28.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.96 / $631.79 / $631.79
| Facility | | $91.96 | $631.79 | $631.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.80 / $56.94 / $87.56
| Facility | | $17.80 | $56.94 | $87.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.71 / $17.80 / $107.00
| Professional | | $15.71 | $17.80 | $107.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.02 / $28.61 / $69.54
| Facility | | $14.02 | $28.61 | $69.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.80 / $23.72 / $33.01
| Professional | | $11.80 | $23.72 | $33.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.94 / $20.94 / $20.94
| Facility | | $20.94 | $20.94 | $20.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.32 / $20.94 / $20.94
| Professional | | $14.32 | $20.94 | $20.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.43 / $12.56 / $35.60
| Professional | | $8.43 | $12.56 | $35.60 |