- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $58.88 / $95.50
| Facility | | $20.89 | $58.88 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $20.89 / $102.33
| Professional | | $15.85 | $20.89 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $31.62 / $138.04
| Facility | | $20.89 | $31.62 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $22.91 / $47.86
| Professional | | $13.49 | $22.91 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $56.23 / $89.13
| Facility | | $44.67 | $56.23 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.38 / $21.38 / $28.84
| Professional | | $21.38 | $21.38 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $36.31 / $87.10
| Facility | | $17.78 | $36.31 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $27.54 / $38.02
| Professional | | $16.60 | $27.54 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $3,630.78 / $9,772.37
| Facility | | $25.70 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $38.02
| Professional | | $32.36 | $32.36 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $69.18
| Professional | | $22.91 | $22.91 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $31.62 / $138.04
| Facility | | $20.89 | $31.62 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $22.91 / $47.86
| Professional | | $13.49 | $22.91 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $22.91 / $38.02
| Facility | | $12.88 | $22.91 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $19.95 / $53.70
| Professional | | $11.22 | $19.95 | $53.70 |