- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $26.92 / $63.10
| Facility | | $8.91 | $26.92 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $8.91 / $45.71
| Professional | | $6.46 | $8.91 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $14.45 / $114.82
| Facility | | $9.33 | $14.45 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.27 / $10.23 / $21.38
| Professional | | $4.27 | $10.23 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.95 / $25.12 / $39.81
| Facility | | $19.95 | $25.12 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $9.55 / $12.88
| Professional | | $9.55 | $9.55 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $16.22 / $38.90
| Facility | | $7.94 | $16.22 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $12.30 / $16.98
| Professional | | $7.41 | $12.30 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.22 / $3,630.78 / $9,772.37
| Facility | | $11.22 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $16.98
| Professional | | $14.45 | $14.45 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $10.23 / $30.90
| Professional | | $10.23 | $10.23 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $14.45 / $114.82
| Facility | | $9.33 | $14.45 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.90 / $10.23 / $21.38
| Professional | | $4.90 | $10.23 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $10.23 / $16.60
| Facility | | $5.89 | $10.23 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $8.51 / $24.55
| Professional | | $3.16 | $8.51 | $24.55 |