- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.30 / $36.31 / $116.48
| Facility | | $17.30 | $36.31 | $116.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.35 / $25.00 / $44.50
| Professional | | $22.35 | $25.00 | $44.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.35 / $58.14 / $100.00
| Facility | | $22.35 | $58.14 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.87 / $24.00 / $29.22
| Professional | | $20.87 | $24.00 | $29.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.17 / $28.51 / $63.16
| Facility | | $24.17 | $28.51 | $63.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.95 / $22.95 / $22.95
| Facility | | $22.95 | $22.95 | $22.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.95 / $22.95 / $22.95
| Professional | | $22.95 | $22.95 | $22.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.63 / $53.00 / $8,090.00
| Facility | | $27.63 | $53.00 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.73 / $23.22 / $48.22
| Professional | | $19.73 | $23.22 | $48.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.85 / $101.73 / $169.09
| Facility | | $0.85 | $101.73 | $169.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.95 / $26.95 / $100.00
| Facility | | $26.95 | $26.95 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.87 / $25.14 / $31.31
| Professional | | $20.87 | $25.14 | $31.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.57 / $39.46 / $81.72
| Facility | | $14.57 | $39.46 | $81.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.79 / $18.28 / $33.53
| Professional | | $13.79 | $18.28 | $33.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.87 / $25.14 / $29.22
| Professional | | $20.87 | $25.14 | $29.22 |