- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.56 / $54.00 / $131.04
| Facility | | $12.56 | $54.00 | $131.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.56 / $14.03 / $94.60
| Professional | | $12.56 | $14.03 | $94.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.16 / $101.50 / $8,639.91
| Facility | | $78.16 | $101.50 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.09 / $12.09 / $12.09
| Professional | | $12.09 | $12.09 | $12.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.19 / $20.65 / $51.07
| Facility | | $10.19 | $20.65 | $51.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $17.76 / $27.08
| Professional | | $9.77 | $17.76 | $27.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.13 / $9.15 / $20.99
| Professional | | $7.13 | $9.15 | $20.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.22 / $60.89 / $126.24
| Facility | | $36.22 | $60.89 | $126.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.50 / $46.13 / $124.55
| Facility | | $14.50 | $46.13 | $124.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.25 / $18.11 / $95.33
| Professional | | $12.25 | $18.11 | $95.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.38 / $23.55 / $51.07
| Facility | | $10.38 | $23.55 | $51.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $17.76 / $27.08
| Professional | | $9.77 | $17.76 | $27.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.50 / $15.50 / $15.50
| Facility | | $15.50 | $15.50 | $15.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.64 / $15.50 / $20.13
| Professional | | $13.64 | $15.50 | $20.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.30 / $15.50 / $26.37
| Professional | | $9.30 | $15.50 | $26.37 |