- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.40 / $36.52 / $146.25
| Facility | | $14.40 | $36.52 | $146.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.61 / $14.71 / $23.22
| Professional | | $11.61 | $14.71 | $23.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.99 / $63.86 / $115.91
| Facility | | $23.99 | $63.86 | $115.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $10.26 / $16.89
| Professional | | $5.00 | $10.26 | $16.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.96 / $18.96 / $19.35
| Facility | | $18.96 | $18.96 | $19.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.52 / $42.52 / $97.85
| Facility | | $13.52 | $42.52 | $97.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.26 / $14.08 / $32.82
| Professional | | $10.26 | $14.08 | $32.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.42 / $91.98 / $100.00
| Facility | | $64.42 | $91.98 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.48 / $19.35 / $25.16
| Facility | | $15.48 | $19.35 | $25.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.34 / $19.35 / $23.96
| Professional | | $18.34 | $19.35 | $23.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.48 / $19.35 / $48.23
| Facility | | $15.48 | $19.35 | $48.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.26 / $14.88 / $27.72
| Professional | | $10.26 | $14.88 | $27.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $11.08 / $19.35
| Professional | | $8.13 | $11.08 | $19.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.55 / $9.56 / $19.35
| Professional | | $7.55 | $9.56 | $19.35 |