- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.03 / $66.13 / $246.00
| Facility | | $24.03 | $66.13 | $246.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.16 / $20.00 / $33.11
| Professional | | $18.16 | $20.00 | $33.11 |
- 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
- Professional
- Modifier
- Low / Median / High Price
- $18.35 / $18.35 / $18.35
| Professional | | $18.35 | $18.35 | $18.35 |
- 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 / $147.61
| Facility | | $14.91 | $23.62 | $147.61 |
- 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
- $15.00 / $33.24 / $262.26
| Facility | | $15.00 | $33.24 | $262.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.04 / $16.38 / $30.81
| Professional | | $12.04 | $16.38 | $30.81 |
- 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 |