- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.82 / $66.56 / $102.39
| Facility | | $19.82 | $66.56 | $102.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.81 / $19.82 / $93.00
| Professional | | $11.81 | $19.82 | $93.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.48 / $86.33 / $8,639.91
| Facility | | $66.48 | $86.33 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.09 / $19.09 / $19.09
| Professional | | $19.09 | $19.09 | $19.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.91 / $31.80 / $71.11
| Facility | | $15.91 | $31.80 | $71.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.23 / $23.61 / $35.11
| Professional | | $8.23 | $23.61 | $35.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $14.44 / $33.15
| Professional | | $8.11 | $14.44 | $33.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.81 / $62.43 / $102.39
| Facility | | $20.81 | $62.43 | $102.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.42 / $20.81 / $101.10
| Professional | | $15.42 | $20.81 | $101.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.91 / $31.82 / $81.50
| Facility | | $15.91 | $31.82 | $81.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.23 / $23.61 / $35.11
| Professional | | $8.23 | $23.61 | $35.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.48 / $24.48 / $24.48
| Facility | | $24.48 | $24.48 | $24.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.78 / $24.48 / $24.48
| Professional | | $18.78 | $24.48 | $24.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.09 / $14.69 / $41.62
| Professional | | $8.09 | $14.69 | $41.62 |