- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $24.24 / $117.27
| Facility | | $10.00 | $24.24 | $117.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.32 / $11.82 / $113.60
| Professional | | $4.32 | $11.82 | $113.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.03 / $13.03 / $33.88
| Facility | | $13.03 | $13.03 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.21 / $6.43 / $20.00
| Professional | | $3.21 | $6.43 | $20.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.82 / $13.03 / $13.03
| Facility | | $7.82 | $13.03 | $13.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.51 / $13.03 / $13.03
| Professional | | $9.51 | $13.03 | $13.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.11 / $27.31 / $62.53
| Facility | | $9.11 | $27.31 | $62.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.76 / $14.61 / $84.46
| Professional | | $9.76 | $14.61 | $84.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.50 / $16.94 / $332.00
| Facility | | $6.50 | $16.94 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.95 / $7.82 / $23.84
| Professional | | $5.95 | $7.82 | $23.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.11 / $8.11 / $8.11
| Facility | | $8.11 | $8.11 | $8.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $11.08 / $15.66
| Professional | | $8.11 | $11.08 | $15.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.49 / $26.27 / $71.08
| Facility | | $10.49 | $26.27 | $71.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.73 / $31.50 / $176.68
| Facility | | $13.73 | $31.50 | $176.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.48 / $10.52 / $26.84
| Professional | | $5.48 | $10.52 | $26.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.15 / $5.86 / $19.14
| Professional | | $5.15 | $5.86 | $19.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.98 / $14.98 / $35.95
| Facility | | $14.98 | $14.98 | $35.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.82 / $12.51 / $20.91
| Professional | | $8.82 | $12.51 | $20.91 |