- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $36.72 / $143.52
| Facility | | $12.88 | $36.72 | $143.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.10 / $26.40 / $26.80
| Professional | | $12.10 | $26.40 | $26.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.97 / $60.00 / $60.00
| Facility | | $20.97 | $60.00 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.44 / $11.04 / $32.20
| Professional | | $6.44 | $11.04 | $32.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.95 / $45.31 / $74.88
| Facility | | $29.95 | $45.31 | $74.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.93 / $17.30 / $17.30
| Professional | | $11.93 | $17.30 | $17.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.08 / $12.85 / $27.41
| Facility | | $12.08 | $12.85 | $27.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.16 / $14.87 / $22.35
| Professional | | $7.16 | $14.87 | $22.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.27 / $17.27 / $20.32
| Professional | | $17.27 | $17.27 | $20.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $15.91 / $49.68
| Professional | | $12.05 | $15.91 | $49.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.04 / $28.83 / $417.04
| Facility | | $19.04 | $28.83 | $417.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.97 / $60.00 / $60.00
| Facility | | $20.97 | $60.00 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $11.04 / $32.20
| Professional | | $6.03 | $11.04 | $32.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.44 / $11.04 / $47.79
| Professional | | $6.44 | $11.04 | $47.79 |