- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.97 / $95.36 / $191.96
| Facility | | $32.97 | $95.36 | $191.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.95 / $26.87 / $35.09
| Professional | | $18.95 | $26.87 | $35.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.55 / $17.55 / $35.09
| Professional | | $17.55 | $17.55 | $35.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.84 / $61.41 / $144.97
| Facility | | $36.84 | $61.41 | $144.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.58 / $72.06 / $263.18
| Professional | | $31.58 | $72.06 | $263.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.79 / $63.64 / $102.65
| Facility | | $23.79 | $63.64 | $102.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.84 / $39.29 / $50.84
| Professional | | $21.84 | $39.29 | $50.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.09 / $51.58 / $108.42
| Facility | | $35.09 | $51.58 | $108.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.09 / $62.10 / $108.73
| Professional | | $35.09 | $62.10 | $108.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.23 / $34.35 / $75.00
| Professional | | $31.23 | $34.35 | $75.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.09 / $35.09 / $73.69
| Facility | | $35.09 | $35.09 | $73.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.09 / $61.41 / $105.27
| Facility | | $35.09 | $61.41 | $105.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.58 / $43.86 / $52.99
| Professional | | $31.58 | $43.86 | $52.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.84 / $57.90 / $96.50
| Facility | | $36.84 | $57.90 | $96.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.92 / $68.02 / $81.27
| Professional | | $40.92 | $68.02 | $81.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.74 / $20.11 / $39.29
| Professional | | $14.74 | $20.11 | $39.29 |