- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.05 / $19.64 / $99.97
| Facility | | $14.05 | $19.64 | $99.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.05 / $14.05 / $44.86
| Professional | | $14.05 | $14.05 | $44.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.29 / $37.63 / $818.35
| Facility | | $12.29 | $37.63 | $818.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.29 / $13.29 / $16.35
| Professional | | $12.29 | $13.29 | $16.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.79 / $19.97 / $42.57
| Facility | | $16.79 | $19.97 | $42.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.75 / $14.75 / $14.75
| Facility | | $14.75 | $14.75 | $14.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.75 / $14.75 / $14.75
| Professional | | $14.75 | $14.75 | $14.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.87 / $18.67 / $37.34
| Professional | | $15.87 | $18.67 | $37.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.30 / $13.30 / $28.20
| Professional | | $11.30 | $13.30 | $28.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.30 / $95.48 / $97.14
| Facility | | $13.30 | $95.48 | $97.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.75 / $42.75 / $100.00
| Facility | | $42.75 | $42.75 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.10 / $15.79 / $19.94
| Professional | | $0.10 | $15.79 | $19.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.10 / $15.28 / $18.61
| Professional | | $0.10 | $15.28 | $18.61 |