- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.75 / $35.60 / $163.56
| Facility | | $12.75 | $35.60 | $163.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.07 / $12.75 / $24.26
| Professional | | $12.07 | $12.75 | $24.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.21 / $28.76 / $85.00
| Facility | | $12.21 | $28.76 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.42 / $13.38 / $32.59
| Professional | | $6.42 | $13.38 | $32.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.66 / $37.68 / $65.88
| Facility | | $23.66 | $37.68 | $65.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.58 / $12.58 / $17.12
| Professional | | $12.58 | $12.58 | $17.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.35 / $19.87 / $45.70
| Facility | | $9.35 | $19.87 | $45.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $14.79 / $22.60
| Professional | | $8.11 | $14.79 | $22.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.19 / $3,472.00 / $9,239.00
| Facility | | $44.19 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.14 / $19.14 / $22.51
| Professional | | $19.14 | $19.14 | $22.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.38 / $18.54 / $49.78
| Professional | | $13.38 | $18.54 | $49.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.75 / $34.86 / $34.86
| Facility | | $15.75 | $34.86 | $34.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.76 / $85.00 / $85.00
| Facility | | $28.76 | $85.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $8.02 / $28.25
| Professional | | $5.25 | $8.02 | $28.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $8.02 / $28.25
| Professional | | $5.25 | $8.02 | $28.25 |