- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.28 / $37.69 / $110.09
| Facility | | $15.28 | $37.69 | $110.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.31 / $15.35 / $24.24
| Professional | | $11.31 | $15.35 | $24.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.69 / $9.69 / $9.69
| Professional | | $9.69 | $9.69 | $9.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.06 / $65.59 / $119.45
| Facility | | $24.06 | $65.59 | $119.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $10.71 / $17.98
| Professional | | $5.00 | $10.71 | $17.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.55 / $20.20 / $20.20
| Facility | | $19.55 | $20.20 | $20.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.12 / $44.38 / $101.79
| Facility | | $14.12 | $44.38 | $101.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.71 / $14.80 / $31.00
| Professional | | $10.71 | $14.80 | $31.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.28 / $118.43 / $236.00
| Facility | | $94.28 | $118.43 | $236.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.16 / $20.20 / $26.26
| Facility | | $16.16 | $20.20 | $26.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.18 / $20.20 / $25.01
| Professional | | $18.18 | $20.20 | $25.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.16 / $20.20 / $46.70
| Facility | | $16.16 | $20.20 | $46.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.71 / $15.55 / $29.18
| Professional | | $10.71 | $15.55 | $29.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.48 / $11.56 / $16.48
| Professional | | $8.48 | $11.56 | $16.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.88 / $9.98 / $20.20
| Professional | | $7.88 | $9.98 | $20.20 |