- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.55 / $75.00 / $138.54
| Facility | | $16.55 | $75.00 | $138.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $16.43 / $18.39
| Professional | | $11.03 | $16.43 | $18.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.27 / $11.03 / $11.03
| Professional | | $8.27 | $11.03 | $11.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.52 / $58.85 / $107.26
| Facility | | $21.52 | $58.85 | $107.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $9.75 / $18.39
| Professional | | $5.00 | $9.75 | $18.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.00 / $28.50 / $112.81
| Facility | | $17.00 | $28.50 | $112.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.79 / $19.30 / $29.42
| Professional | | $13.79 | $19.30 | $29.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.02 / $18.02 / $18.39
| Facility | | $18.02 | $18.02 | $18.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.85 / $40.15 / $83.65
| Facility | | $12.85 | $40.15 | $83.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.75 / $13.36 / $38.36
| Professional | | $9.75 | $13.36 | $38.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.19 / $96.88 / $96.88
| Facility | | $76.19 | $96.88 | $96.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.55 / $27.39 / $30.59
| Professional | | $16.55 | $27.39 | $30.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.71 / $18.39 / $28.27
| Facility | | $14.71 | $18.39 | $28.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.55 / $18.39 / $30.51
| Professional | | $16.55 | $18.39 | $30.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.59 / $162.28 / $649.91
| Facility | | $118.59 | $162.28 | $649.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.71 / $18.39 / $46.23
| Facility | | $14.71 | $18.39 | $46.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.75 / $14.16 / $26.58
| Professional | | $9.75 | $14.16 | $26.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.72 / $10.60 / $15.22
| Professional | | $7.72 | $10.60 | $15.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.17 / $9.08 / $18.39
| Professional | | $7.17 | $9.08 | $18.39 |