- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $46.77 / $87.10
| Facility | | $20.42 | $46.77 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $19.05 / $91.20
| Professional | | $12.88 | $19.05 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.62 / $28.84 / $141.25
| Facility | | $18.62 | $28.84 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $20.42 / $42.66
| Professional | | $12.30 | $20.42 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $50.12 / $79.43
| Facility | | $39.81 | $50.12 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $19.05 / $26.30
| Professional | | $19.05 | $19.05 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.85 / $32.36 / $79.43
| Facility | | $15.85 | $32.36 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $24.55 / $34.67
| Professional | | $14.79 | $24.55 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $3,630.78 / $9,772.37
| Facility | | $29.51 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $29.51 / $34.67
| Professional | | $29.51 | $29.51 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $20.42 / $61.66
| Professional | | $20.42 | $20.42 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $74.13 / $77.62
| Facility | | $44.67 | $74.13 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.62 / $28.84 / $141.25
| Facility | | $18.62 | $28.84 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $20.42 / $42.66
| Professional | | $12.30 | $20.42 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $20.42 / $33.11
| Facility | | $11.75 | $20.42 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $17.78 / $48.98
| Professional | | $10.00 | $17.78 | $48.98 |