- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $38.90 / $66.07
| Facility | | $14.13 | $38.90 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $12.02 / $26.92
| Professional | | $8.91 | $12.02 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $77.62 / $5,011.87
| Facility | | $58.88 | $77.62 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $11.75 / $11.75
| Professional | | $11.75 | $11.75 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $22.91 / $51.29
| Facility | | $10.00 | $22.91 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.24 / $15.14 / $22.39
| Professional | | $7.24 | $15.14 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $8.91 / $21.88
| Professional | | $7.08 | $8.91 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $15.14 / $15.14
| Facility | | $15.14 | $15.14 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $15.14 / $26.30
| Professional | | $11.48 | $15.14 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $37.15 / $66.07
| Facility | | $14.13 | $37.15 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $12.88 / $51.29
| Professional | | $10.00 | $12.88 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $9.12 / $15.14
| Facility | | $5.89 | $9.12 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $12.59 / $17.38
| Professional | | $6.61 | $12.59 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $15.14 / $18.20
| Facility | | $8.32 | $15.14 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.31 / $9.55 / $22.39
| Professional | | $6.31 | $9.55 | $22.39 |