- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.81 / $87.63 / $412.87
| Facility | | $11.81 | $87.63 | $412.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.48 / $10.46 / $16.96
| Professional | | $8.48 | $10.46 | $16.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.89 / $40.40 / $74.47
| Facility | | $9.89 | $40.40 | $74.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $7.49 / $9.89
| Professional | | $5.00 | $7.49 | $9.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.72 / $21.20 / $99.20
| Facility | | $12.72 | $21.20 | $99.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.78 / $19.78 / $19.78
| Professional | | $19.78 | $19.78 | $19.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.81 / $14.13 / $14.13
| Facility | | $13.81 | $14.13 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.61 / $26.60 / $61.32
| Facility | | $9.61 | $26.60 | $61.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.49 / $11.97 / $21.69
| Professional | | $7.49 | $11.97 | $21.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.34 / $80.54 / $80.54
| Facility | | $63.34 | $80.54 | $80.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.11 / $17.48 / $23.62
| Professional | | $12.11 | $17.48 | $23.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.74 / $14.13 / $23.19
| Facility | | $10.74 | $14.13 | $23.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.01 / $14.13 / $16.64
| Professional | | $12.01 | $14.13 | $16.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $364.00 / $465.00 / $638.00
| Facility | | $364.00 | $465.00 | $638.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.68 / $14.13 / $32.85
| Facility | | $10.68 | $14.13 | $32.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.49 / $11.49 / $17.39
| Professional | | $7.49 | $11.49 | $17.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.93 / $7.04 / $12.57
| Professional | | $5.93 | $7.04 | $12.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.51 / $5.92 / $14.13
| Professional | | $5.51 | $5.92 | $14.13 |