- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $27.54 / $51.29
| Facility | | $7.94 | $27.54 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $12.02 / $41.69
| Professional | | $7.94 | $12.02 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $18.62 / $75.86
| Facility | | $12.02 | $18.62 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $14.79 / $33.11
| Professional | | $6.61 | $14.79 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $32.36 / $46.77
| Facility | | $25.70 | $32.36 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $15.14 / $15.85
| Professional | | $12.02 | $15.14 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $21.88 / $51.29
| Facility | | $10.47 | $21.88 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $19.50 / $23.99
| Professional | | $9.77 | $19.50 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $3,630.78 / $9,772.37
| Facility | | $10.47 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $26.92
| Professional | | $22.91 | $22.91 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $15.85 / $34.67
| Professional | | $15.85 | $15.85 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $18.62 / $75.86
| Facility | | $12.02 | $18.62 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $14.79 / $33.11
| Professional | | $6.61 | $14.79 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.76 / $15.85 / $21.38
| Facility | | $7.76 | $15.85 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $9.55 / $30.20
| Professional | | $5.25 | $9.55 | $30.20 |