- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.87 / $163.80 / $394.45
| Facility | | $23.87 | $163.80 | $394.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.14 / $35.18 / $91.77
| Professional | | $25.14 | $35.18 | $91.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.55 / $42.11 / $55.79
| Professional | | $17.55 | $42.11 | $55.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.61 / $84.64 / $312.00
| Facility | | $37.61 | $84.64 | $312.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.88 / $30.96 / $102.58
| Professional | | $19.88 | $30.96 | $102.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.10 / $97.90 / $442.83
| Facility | | $57.10 | $97.90 | $442.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.86 / $31.07 / $100.00
| Professional | | $24.86 | $31.07 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.78 / $60.67 / $128.69
| Facility | | $25.78 | $60.67 | $128.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.92 / $37.72 / $173.64
| Professional | | $22.92 | $37.72 | $173.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.36 / $35.09 / $47.37
| Professional | | $25.36 | $35.09 | $47.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.58 / $40.35 / $79.52
| Professional | | $31.58 | $40.35 | $79.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.45 / $167.46 / $167.46
| Facility | | $73.45 | $167.46 | $167.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.77 / $313.33 / $313.33
| Professional | | $71.77 | $313.33 | $313.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.11 / $42.11 / $42.11
| Professional | | $42.11 | $42.11 | $42.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.04 / $58.62 / $111.13
| Facility | | $34.04 | $58.62 | $111.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.76 / $43.86 / $107.97
| Professional | | $25.76 | $43.86 | $107.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.16 / $123.16 / $123.16
| Professional | | $123.16 | $123.16 | $123.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.07 / $35.79 / $59.65
| Professional | | $28.07 | $35.79 | $59.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.74 / $21.05 / $90.29
| Professional | | $14.74 | $21.05 | $90.29 |