- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $60.26 / $107.15
| Facility | | $33.88 | $60.26 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $35.48 / $66.07
| Professional | | $32.36 | $35.48 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $45.71 / $79.43
| Facility | | $38.90 | $45.71 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.38 / $26.30 / $56.23
| Professional | | $21.38 | $26.30 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.98 / $48.98 / $48.98
| Facility | | $48.98 | $48.98 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $57.54 / $57.54
| Professional | | $57.54 | $57.54 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.54 / $27.54 / $162.18
| Facility | | $27.54 | $27.54 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $38.90 / $102.33
| Professional | | $21.88 | $38.90 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $43.65 / $162.18
| Facility | | $38.02 | $43.65 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $38.90 / $85.11
| Professional | | $21.88 | $38.90 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $38.90 / $52.48
| Professional | | $32.36 | $38.90 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $51.29 / $51.29
| Facility | | $51.29 | $51.29 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $44.67 / $100.00
| Professional | | $32.36 | $44.67 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.49 / $38.90 / $42.66
| Facility | | $15.49 | $38.90 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $25.70 / $58.88
| Professional | | $8.91 | $25.70 | $58.88 |