- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $39.81 / $95.50
| Facility | | $15.14 | $39.81 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $14.13 / $69.18
| Professional | | $10.96 | $14.13 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $21.38 / $89.13
| Facility | | $13.80 | $21.38 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $15.14 / $32.36
| Professional | | $6.46 | $15.14 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $37.15 / $58.88
| Facility | | $29.51 | $37.15 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $19.50
| Professional | | $14.45 | $14.45 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $24.55 / $58.88
| Facility | | $12.02 | $24.55 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $18.62 / $25.70
| Professional | | $11.22 | $18.62 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $3,630.78 / $9,772.37
| Facility | | $21.88 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $21.88 / $25.70
| Professional | | $21.88 | $21.88 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $15.14 / $46.77
| Professional | | $15.14 | $15.14 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.22 / $16.22 / $19.95
| Facility | | $16.22 | $16.22 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $21.38 / $89.13
| Facility | | $13.80 | $21.38 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $15.14 / $32.36
| Professional | | $7.41 | $15.14 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.71 / $15.14 / $25.12
| Facility | | $8.71 | $15.14 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $12.88 / $36.31
| Professional | | $5.25 | $12.88 | $36.31 |