- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.71 / $94.13 / $107.60
| Facility | | $20.71 | $94.13 | $107.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.73 / $21.09 / $42.50
| Professional | | $19.73 | $21.09 | $42.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.92 / $159.62 / $8,639.91
| Facility | | $122.92 | $159.62 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.01 / $19.01 / $19.01
| Professional | | $19.01 | $19.01 | $19.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.01 / $32.45 / $80.41
| Facility | | $16.01 | $32.45 | $80.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.22 / $28.08 / $42.74
| Professional | | $15.22 | $28.08 | $42.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.21 / $14.38 / $33.00
| Professional | | $11.21 | $14.38 | $33.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.11 / $77.06 / $141.00
| Facility | | $32.11 | $77.06 | $141.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.62 / $14.62 / $23.50
| Professional | | $14.62 | $14.62 | $23.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.71 / $66.27 / $106.60
| Facility | | $20.71 | $66.27 | $106.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.28 / $21.25 / $100.65
| Professional | | $18.28 | $21.25 | $100.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.32 / $37.03 / $80.41
| Facility | | $16.32 | $37.03 | $80.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.22 / $28.08 / $42.74
| Professional | | $15.22 | $28.08 | $42.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.37 / $24.37 / $24.37
| Facility | | $24.37 | $24.37 | $24.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.45 / $24.37 / $34.69
| Professional | | $21.45 | $24.37 | $34.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.50 / $15.11 / $44.60
| Professional | | $10.50 | $15.11 | $44.60 |