- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.67 / $20.67 / $38.45
| Facility | | $20.67 | $20.67 | $38.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.57 / $25.00 / $32.78
| Professional | | $18.57 | $25.00 | $32.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.50 / $28.57 / $241.21
| Facility | | $18.50 | $28.57 | $241.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.34 / $26.10 / $221.32
| Professional | | $14.34 | $26.10 | $221.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.51 / $228.40 / $413.78
| Facility | | $165.51 | $228.40 | $413.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.39 / $25.23 / $67.84
| Facility | | $1.39 | $25.23 | $67.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.42 / $25.39 / $70.27
| Professional | | $12.42 | $25.39 | $70.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.38 / $35.47 / $41.73
| Professional | | $16.38 | $35.47 | $41.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.13 / $31.13 / $129.05
| Professional | | $31.13 | $31.13 | $129.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.72 / $142.72 / $142.72
| Facility | | $142.72 | $142.72 | $142.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.83 / $139.41 / $139.41
| Facility | | $48.83 | $139.41 | $139.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.86 / $24.14 / $221.32
| Professional | | $12.86 | $24.14 | $221.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.32 / $23.27 / $70.33
| Professional | | $10.32 | $23.27 | $70.33 |