- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.18 / $24.18 / $44.97
| Facility | | $24.18 | $24.18 | $44.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.61 / $30.08 / $90.48
| Professional | | $21.61 | $30.08 | $90.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.31 / $54.25 / $111.53
| Facility | | $24.31 | $54.25 | $111.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.30 / $34.61 / $151.33
| Professional | | $23.30 | $34.61 | $151.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.58 / $60.00 / $80.26
| Facility | | $50.58 | $60.00 | $80.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.96 / $22.21 / $40.15
| Professional | | $12.96 | $22.21 | $40.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.30 / $26.30 / $26.30
| Facility | | $26.30 | $26.30 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.68 / $41.35 / $74.65
| Professional | | $25.68 | $41.35 | $74.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.72 / $53.00 / $6,679.00
| Facility | | $26.72 | $53.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.36 / $24.81 / $40.65
| Professional | | $13.36 | $24.81 | $40.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.04 / $50.28 / $72.83
| Professional | | $26.04 | $50.28 | $72.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.97 / $46.22 / $74.50
| Professional | | $35.97 | $46.22 | $74.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.13 / $111.53 / $111.53
| Facility | | $54.13 | $111.53 | $111.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.07 / $39.29 / $151.44
| Professional | | $28.07 | $39.29 | $151.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.85 / $35.09 / $70.09
| Professional | | $27.85 | $35.09 | $70.09 |