- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.37 / $63.08 / $252.00
| Facility | | $23.37 | $63.08 | $252.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.96 / $20.45 / $22.02
| Professional | | $16.96 | $20.45 | $22.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.93 / $15.93 / $35.56
| Professional | | $15.93 | $15.93 | $35.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.26 / $25.23 / $40.60
| Facility | | $20.26 | $25.23 | $40.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.33 / $11.33 / $24.77
| Professional | | $11.33 | $11.33 | $24.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $14.45
| Facility | | $14.45 | $14.45 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.65 / $22.94 / $30.97
| Facility | | $15.65 | $22.94 | $30.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.50 / $29.82 / $30.97
| Professional | | $19.50 | $29.82 | $30.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.91 / $23.62 / $76.84
| Facility | | $14.91 | $23.62 | $76.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.72 / $18.41 / $33.39
| Professional | | $11.72 | $18.41 | $33.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.91 / $28.93 / $162.21
| Facility | | $14.91 | $28.93 | $162.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.28 / $18.48 / $43.15
| Professional | | $14.28 | $18.48 | $43.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.21 / $18.93 / $27.53
| Professional | | $17.21 | $18.93 | $27.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.63 / $13.76 / $32.06
| Professional | | $9.63 | $13.76 | $32.06 |