- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.17 / $40.84 / $62.84
| Facility | | $12.17 | $40.84 | $62.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.41 / $12.17 / $62.03
| Professional | | $10.41 | $12.17 | $62.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.61 / $76.11 / $8,639.91
| Facility | | $58.61 | $76.11 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.72 / $11.72 / $11.72
| Professional | | $11.72 | $11.72 | $11.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.86 / $20.00 / $49.98
| Facility | | $9.86 | $20.00 | $49.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.47 / $16.93 / $26.23
| Professional | | $9.47 | $16.93 | $26.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.91 / $8.86 / $20.34
| Professional | | $6.91 | $8.86 | $20.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.77 / $40.84 / $62.84
| Facility | | $12.77 | $40.84 | $62.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.81 / $12.77 / $62.03
| Professional | | $10.81 | $12.77 | $62.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.05 / $22.82 / $49.98
| Facility | | $10.05 | $22.82 | $49.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.47 / $16.93 / $26.23
| Professional | | $9.47 | $16.93 | $26.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.02 / $15.02 / $15.02
| Facility | | $15.02 | $15.02 | $15.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.22 / $15.02 / $16.54
| Professional | | $13.22 | $15.02 | $16.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.52 / $18.02 / $18.02
| Facility | | $13.52 | $18.02 | $18.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $9.31 / $27.49
| Professional | | $6.76 | $9.31 | $27.49 |