- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.32 / $35.33 / $98.00
| Facility | | $14.32 | $35.33 | $98.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $14.39 / $22.72
| Professional | | $10.60 | $14.39 | $22.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.47 / $62.66 / $113.96
| Facility | | $23.47 | $62.66 | $113.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $10.02 / $15.14
| Professional | | $5.00 | $10.02 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.93 / $18.93 / $21.81
| Facility | | $18.93 | $18.93 | $21.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.23 / $41.57 / $95.18
| Facility | | $13.23 | $41.57 | $95.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.02 / $13.90 / $31.73
| Professional | | $10.02 | $13.90 | $31.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.90 / $123.00 / $123.00
| Facility | | $96.90 | $123.00 | $123.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $18.93 / $24.61
| Facility | | $15.14 | $18.93 | $24.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.04 / $18.93 / $24.67
| Professional | | $17.04 | $18.93 | $24.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $18.93 / $52.25
| Facility | | $15.14 | $18.93 | $52.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.02 / $14.56 / $27.13
| Professional | | $10.02 | $14.56 | $27.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.95 / $10.84 / $15.66
| Professional | | $7.95 | $10.84 | $15.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.38 / $9.35 / $18.93
| Professional | | $7.38 | $9.35 | $18.93 |