- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $36.31 / $51.29
| Facility | | $10.00 | $36.31 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $12.02 / $51.29
| Professional | | $10.00 | $12.02 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $18.20 / $75.86
| Facility | | $11.75 | $18.20 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $14.79 / $33.11
| Professional | | $9.55 | $14.79 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.12 / $31.62 / $47.86
| Facility | | $25.12 | $31.62 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $15.14 / $15.85
| Professional | | $14.79 | $15.14 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.22 / $20.89 / $46.77
| Facility | | $11.22 | $20.89 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $19.50 / $23.99
| Professional | | $9.12 | $19.50 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $3,630.78 / $9,772.37
| Facility | | $16.60 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $26.92
| Professional | | $22.91 | $22.91 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $15.85 / $36.31
| Professional | | $15.85 | $15.85 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $18.20 / $75.86
| Facility | | $11.75 | $18.20 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $15.85 / $33.11
| Professional | | $9.55 | $15.85 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $15.85 / $19.50
| Facility | | $7.94 | $15.85 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $14.45 / $32.36
| Professional | | $7.76 | $14.45 | $32.36 |