- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $50.12 / $83.18
| Facility | | $17.78 | $50.12 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $15.85 / $56.23
| Professional | | $14.13 | $15.85 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $131.83 / $5,011.87
| Facility | | $100.00 | $131.83 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $14.79 / $18.62
| Professional | | $14.79 | $14.79 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $29.51 / $64.57
| Facility | | $12.59 | $29.51 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $21.38 / $33.11
| Professional | | $11.75 | $21.38 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $19.05 / $27.54
| Professional | | $8.91 | $19.05 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $19.05 / $19.05
| Facility | | $19.05 | $19.05 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.62 / $21.38 / $33.11
| Professional | | $18.62 | $21.38 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.62 / $31.62 / $112.20
| Facility | | $31.62 | $31.62 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $50.12 / $85.11
| Facility | | $17.78 | $50.12 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $16.98 / $77.62
| Professional | | $12.88 | $16.98 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $25.12 / $28.18
| Facility | | $19.05 | $25.12 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $25.12 / $28.18
| Professional | | $17.38 | $25.12 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $19.05 / $22.91
| Facility | | $12.59 | $19.05 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $12.30 / $33.11
| Professional | | $7.94 | $12.30 | $33.11 |