- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.48 / $59.66 / $263.16
| Facility | | $10.48 | $59.66 | $263.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.07 / $10.13 / $20.62
| Professional | | $8.07 | $10.13 | $20.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.54 / $6.92 / $7.21
| Professional | | $5.54 | $6.92 | $7.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.91 / $36.20 / $65.38
| Facility | | $12.91 | $36.20 | $65.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $6.11 / $11.30
| Professional | | $5.00 | $6.11 | $11.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.53 / $15.57 / $35.72
| Facility | | $11.53 | $15.57 | $35.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.07 / $10.38 / $18.45
| Professional | | $8.07 | $10.38 | $18.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.10 / $12.10 / $12.10
| Facility | | $12.10 | $12.10 | $12.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.98 / $19.53 / $51.36
| Facility | | $7.98 | $19.53 | $51.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.67 / $6.46 / $22.19
| Professional | | $4.67 | $6.46 | $22.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.93 / $60.00 / $60.00
| Facility | | $20.93 | $60.00 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.38 / $11.53 / $19.32
| Professional | | $10.38 | $11.53 | $19.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.65 / $11.53 / $12.68
| Facility | | $8.65 | $11.53 | $12.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.80 / $11.53 / $20.93
| Professional | | $9.80 | $11.53 | $20.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.61 / $215.69 / $719.63
| Facility | | $157.61 | $215.69 | $719.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.52 / $11.53 / $16.03
| Facility | | $8.52 | $11.53 | $16.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.87 / $10.95 / $12.16
| Professional | | $5.87 | $10.95 | $12.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $4.84 / $6.92
| Professional | | $4.84 | $4.84 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.50 / $4.61 / $11.53
| Professional | | $4.50 | $4.61 | $11.53 |