- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.85 / $73.09 / $117.56
| Facility | | $22.85 | $73.09 | $117.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.51 / $22.04 / $26.38
| Professional | | $15.51 | $22.04 | $26.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.10 / $134.72 / $8,459.92
| Facility | | $101.10 | $134.72 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.97 / $20.97 / $20.97
| Professional | | $20.97 | $20.97 | $20.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.64 / $39.65 / $89.10
| Facility | | $22.64 | $39.65 | $89.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.43 / $24.73 / $48.32
| Professional | | $12.43 | $24.73 | $48.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.00 / $36.29 / $51.07
| Professional | | $16.00 | $36.29 | $51.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.43 / $53.53 / $57.36
| Facility | | $35.43 | $53.53 | $57.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.14 / $68.55 / $117.56
| Facility | | $25.14 | $68.55 | $117.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.35 / $23.98 / $111.01
| Professional | | $19.35 | $23.98 | $111.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.85 / $31.00 / $53.76
| Professional | | $22.85 | $31.00 | $53.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.64 / $41.56 / $89.10
| Facility | | $22.64 | $41.56 | $89.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.58 / $25.35 / $48.32
| Professional | | $12.58 | $25.35 | $48.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.88 / $26.88 / $26.88
| Facility | | $26.88 | $26.88 | $26.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.88 / $26.88 / $27.42
| Professional | | $26.88 | $26.88 | $27.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.29 / $16.13 / $37.63
| Professional | | $11.29 | $16.13 | $37.63 |