- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.16 / $104.85 / $187.55
| Facility | | $22.16 | $104.85 | $187.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.60 / $23.23 / $34.29
| Professional | | $20.60 | $23.23 | $34.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.46 / $170.71 / $8,639.91
| Facility | | $131.46 | $170.71 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.32 / $20.32 / $20.32
| Professional | | $20.32 | $20.32 | $20.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.14 / $34.72 / $86.93
| Facility | | $17.14 | $34.72 | $86.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.30 / $30.15 / $45.70
| Professional | | $16.30 | $30.15 | $45.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.99 / $20.86 / $35.29
| Professional | | $11.99 | $20.86 | $35.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.44 / $72.20 / $168.80
| Facility | | $44.44 | $72.20 | $168.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.64 / $22.16 / $25.00
| Professional | | $15.64 | $22.16 | $25.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.16 / $74.30 / $187.55
| Facility | | $22.16 | $74.30 | $187.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.17 / $23.34 / $107.67
| Professional | | $20.17 | $23.34 | $107.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.46 / $39.60 / $86.93
| Facility | | $17.46 | $39.60 | $86.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.30 / $30.15 / $45.70
| Professional | | $16.30 | $30.15 | $45.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.07 / $26.07 / $26.07
| Facility | | $26.07 | $26.07 | $26.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.94 / $26.07 / $37.10
| Professional | | $22.94 | $26.07 | $37.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.73 / $16.80 / $47.71
| Professional | | $11.73 | $16.80 | $47.71 |