- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $39.81 / $169.82
| Facility | | $12.88 | $39.81 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $12.30 / $39.81
| Professional | | $8.91 | $12.30 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $19.50 / $223.87
| Facility | | $12.59 | $19.50 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $13.80 / $28.84
| Professional | | $5.75 | $13.80 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $33.88 / $53.70
| Facility | | $26.92 | $33.88 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $12.88 / $17.38
| Professional | | $12.88 | $12.88 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $21.88 / $52.48
| Facility | | $10.72 | $21.88 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $16.60 / $22.91
| Professional | | $10.00 | $16.60 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.30 / $3,630.78 / $9,772.37
| Facility | | $12.30 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.50 / $19.50 / $22.91
| Professional | | $19.50 | $19.50 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $13.80 / $41.69
| Professional | | $13.80 | $13.80 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.30 / $17.78 / $338.84
| Facility | | $12.30 | $17.78 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $19.50 / $223.87
| Facility | | $12.59 | $19.50 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $13.80 / $28.84
| Professional | | $6.61 | $13.80 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $13.80 / $22.39
| Facility | | $7.94 | $13.80 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $11.48 / $32.36
| Professional | | $5.25 | $11.48 | $32.36 |