- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $51.29 / $95.50
| Facility | | $8.91 | $51.29 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $22.91 / $72.44
| Professional | | $10.96 | $22.91 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.38 / $32.36 / $91.20
| Facility | | $21.38 | $32.36 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $29.51 / $109.65
| Professional | | $12.30 | $29.51 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $57.54 / $83.18
| Facility | | $46.77 | $57.54 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $27.54 / $27.54
| Professional | | $12.59 | $27.54 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $40.74 / $79.43
| Facility | | $20.89 | $40.74 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $34.67 / $75.86
| Professional | | $15.85 | $34.67 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $3,630.78 / $9,772.37
| Facility | | $14.45 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $41.69 / $48.98
| Professional | | $41.69 | $41.69 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $29.51 / $48.98
| Professional | | $29.51 | $29.51 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.38 / $32.36 / $91.20
| Facility | | $21.38 | $32.36 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $29.51 / $114.82
| Professional | | $12.30 | $29.51 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.38 / $29.51 / $34.67
| Facility | | $17.38 | $29.51 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $18.62 / $52.48
| Professional | | $8.32 | $18.62 | $52.48 |