- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.18 / $81.17 / $131.80
| Facility | | $24.18 | $81.17 | $131.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.58 / $26.61 / $29.85
| Professional | | $23.58 | $26.61 | $29.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.56 / $195.51 / $8,639.91
| Facility | | $150.56 | $195.51 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.28 / $23.28 / $23.28
| Professional | | $23.28 | $23.28 | $23.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.62 / $39.74 / $98.88
| Facility | | $19.62 | $39.74 | $98.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.79 / $34.28 / $52.47
| Professional | | $18.79 | $34.28 | $52.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.73 / $17.61 / $40.42
| Professional | | $13.73 | $17.61 | $40.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.20 / $13.20 / $13.20
| Facility | | $13.20 | $13.20 | $13.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.17 / $81.17 / $131.80
| Facility | | $24.17 | $81.17 | $131.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.49 / $26.72 / $123.28
| Professional | | $21.49 | $26.72 | $123.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.98 / $45.34 / $98.88
| Facility | | $19.98 | $45.34 | $98.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.79 / $34.28 / $52.47
| Professional | | $18.79 | $34.28 | $52.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.85 / $29.85 / $29.85
| Facility | | $29.85 | $29.85 | $29.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.27 / $29.85 / $42.50
| Professional | | $26.27 | $29.85 | $42.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.54 / $17.91 / $51.94
| Professional | | $12.54 | $17.91 | $51.94 |