- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.81 / $36.54 / $104.81
| Facility | | $14.81 | $36.54 | $104.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $14.89 / $23.51
| Professional | | $11.75 | $14.89 | $23.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.18 / $64.65 / $117.34
| Facility | | $24.18 | $64.65 | $117.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $10.38 / $17.10
| Professional | | $5.00 | $10.38 | $17.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.59 / $19.59 / $19.59
| Facility | | $19.59 | $19.59 | $19.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.69 / $42.77 / $91.18
| Facility | | $13.69 | $42.77 | $91.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.38 / $14.02 / $32.82
| Professional | | $10.38 | $14.02 | $32.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $93.18 / $93.18
| Facility | | $80.00 | $93.18 | $93.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.69 / $19.59 / $23.36
| Facility | | $14.69 | $19.59 | $23.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.64 / $19.59 / $24.26
| Professional | | $18.64 | $19.59 | $24.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.89 / $19.59 / $49.48
| Facility | | $14.89 | $19.59 | $49.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.38 / $15.08 / $28.29
| Professional | | $10.38 | $15.08 | $28.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.23 / $11.31 / $16.00
| Professional | | $8.23 | $11.31 | $16.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.64 / $9.67 / $19.59
| Professional | | $7.64 | $9.67 | $19.59 |