- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.76 / $82.14 / $347.21
| Facility | | $13.76 | $82.14 | $347.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.10 / $9.80 / $14.41
| Professional | | $8.10 | $9.80 | $14.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.80 / $10.80 / $52.60
| Facility | | $10.80 | $10.80 | $52.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.34 / $5.34 / $6.53
| Professional | | $5.34 | $5.34 | $6.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.19 / $27.80 / $41.61
| Professional | | $18.19 | $27.80 | $41.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.55 / $27.06 / $55.36
| Facility | | $7.55 | $27.06 | $55.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.12 / $7.31 / $12.39
| Professional | | $6.12 | $7.31 | $12.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.96 / $13.50 / $15.98
| Professional | | $12.96 | $13.50 | $15.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.96 / $9.80 / $17.39
| Facility | | $8.96 | $9.80 | $17.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.85 / $20.00 / $27.00
| Professional | | $14.85 | $20.00 | $27.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.40 / $14.83 / $4,071.00
| Facility | | $8.40 | $14.83 | $4,071.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.40 / $14.74 / $4,071.00
| Professional | | $8.40 | $14.74 | $4,071.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.00 / $18.00 / $18.00
| Facility | | $18.00 | $18.00 | $18.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.60 / $5.40 / $8.91
| Professional | | $3.60 | $5.40 | $8.91 |