- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.85 / $51.29 / $204.17
| Facility | | $15.85 | $51.29 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $15.85 / $79.43
| Professional | | $12.88 | $15.85 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.22 / $25.12 / $177.83
| Facility | | $16.22 | $25.12 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $17.78 / $37.15
| Professional | | $8.32 | $17.78 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $42.66 / $69.18
| Facility | | $34.67 | $42.66 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $16.60 / $22.39
| Professional | | $16.60 | $16.60 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $28.18 / $67.61
| Facility | | $13.80 | $28.18 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $21.38 / $29.51
| Professional | | $12.88 | $21.38 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.12 / $3,630.78 / $9,772.37
| Facility | | $25.12 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $25.70 / $30.20
| Professional | | $25.70 | $25.70 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $17.78 / $53.70
| Professional | | $17.78 | $17.78 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $38.90 / $257.04
| Facility | | $16.60 | $38.90 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.22 / $25.12 / $177.83
| Facility | | $16.22 | $25.12 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.51 / $17.78 / $37.15
| Professional | | $8.51 | $17.78 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $17.78 / $29.51
| Facility | | $10.00 | $17.78 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $14.79 / $41.69
| Professional | | $8.32 | $14.79 | $41.69 |