- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $38.02 / $63.10
| Facility | | $15.14 | $38.02 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $12.02 / $35.48
| Professional | | $10.00 | $12.02 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $100.00 / $5,011.87
| Facility | | $75.86 | $100.00 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $11.22 / $14.13
| Professional | | $11.22 | $11.22 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $21.88 / $48.98
| Facility | | $9.55 | $21.88 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $16.22 / $25.12
| Professional | | $8.91 | $16.22 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $8.51 / $20.89
| Professional | | $6.76 | $8.51 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $14.45
| Facility | | $14.45 | $14.45 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $16.22 / $25.12
| Professional | | $14.45 | $16.22 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.18 / $28.84 / $61.66
| Facility | | $28.18 | $28.84 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $8.71 / $8.71
| Professional | | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $38.02 / $67.61
| Facility | | $15.14 | $38.02 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $14.45 / $52.48
| Professional | | $10.00 | $14.45 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $12.88 / $15.85
| Facility | | $12.59 | $12.88 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $12.88 / $20.42
| Professional | | $3.47 | $12.88 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $14.45 / $17.38
| Facility | | $9.55 | $14.45 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $9.33 / $25.12
| Professional | | $6.03 | $9.33 | $25.12 |