- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.62 / $91.20 / $389.05
| Facility | | $18.62 | $91.20 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $10.96 / $218.78
| Professional | | $8.91 | $10.96 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $31.62 / $43.65
| Facility | | $19.50 | $31.62 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $21.38 / $50.12
| Professional | | $9.33 | $21.38 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $64.57 / $72.44
| Professional | | $12.02 | $64.57 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $17.38 / $173.78
| Facility | | $12.02 | $17.38 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $16.60 / $25.12
| Professional | | $12.02 | $16.60 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $13.18 / $26.30
| Facility | | $12.02 | $13.18 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $14.45
| Professional | | $12.02 | $12.02 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $19.50 / $43.65
| Facility | | $14.45 | $19.50 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $16.98 / $50.12
| Professional | | $12.02 | $16.98 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $36.31 / $50.12
| Facility | | $18.20 | $36.31 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $12.02 / $15.49
| Professional | | $9.12 | $12.02 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $19.50
| Facility | | $14.45 | $14.45 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $6.92 / $16.98
| Professional | | $5.01 | $6.92 | $16.98 |