- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $37.15 / $60.26
| Facility | | $12.88 | $37.15 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $12.88 / $63.10
| Professional | | $10.00 | $12.88 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $19.95 / $100.00
| Facility | | $12.88 | $19.95 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $15.49 / $32.36
| Professional | | $9.33 | $15.49 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.18 / $35.48 / $56.23
| Facility | | $28.18 | $35.48 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $18.20
| Professional | | $14.45 | $14.45 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.48 / $22.39 / $54.95
| Facility | | $11.48 | $22.39 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $19.05 / $23.99
| Professional | | $10.23 | $19.05 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.38 / $3,630.78 / $9,772.37
| Facility | | $21.38 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.39 / $22.39 / $26.30
| Professional | | $22.39 | $22.39 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.49 / $15.49 / $42.66
| Professional | | $15.49 | $15.49 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $19.95 / $100.00
| Facility | | $12.88 | $19.95 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $15.49 / $32.36
| Professional | | $9.33 | $15.49 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $15.49 / $23.99
| Facility | | $8.13 | $15.49 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $11.75 / $33.88
| Professional | | $7.41 | $11.75 | $33.88 |