- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.00 / $72.89 / $311.55
| Facility | | $15.00 | $72.89 | $311.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.94 / $15.76 / $28.85
| Professional | | $13.94 | $15.76 | $28.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.01 / $115.58 / $8,639.91
| Facility | | $89.01 | $115.58 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.77 / $13.77 / $13.77
| Professional | | $13.77 | $13.77 | $13.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.60 / $23.50 / $58.68
| Facility | | $11.60 | $23.50 | $58.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $20.65 / $30.89
| Professional | | $11.03 | $20.65 | $30.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $14.12 / $23.90
| Professional | | $8.11 | $14.12 | $23.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.82 / $43.66 / $157.65
| Facility | | $27.82 | $43.66 | $157.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.59 / $10.59 / $17.00
| Professional | | $10.59 | $10.59 | $17.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.41 / $48.33 / $216.68
| Facility | | $19.41 | $48.33 | $216.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.66 / $16.00 / $72.89
| Professional | | $13.66 | $16.00 | $72.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.81 / $26.81 / $58.68
| Facility | | $11.81 | $26.81 | $58.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $20.65 / $30.89
| Professional | | $11.03 | $20.65 | $30.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.64 / $17.64 / $17.64
| Facility | | $17.64 | $17.64 | $17.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.53 / $17.64 / $25.12
| Professional | | $15.53 | $17.64 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $10.94 / $32.29
| Professional | | $7.94 | $10.94 | $32.29 |