- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $17.54 / $21.04
| Facility | | $14.45 | $17.54 | $21.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.23 / $19.70 / $31.63
| Professional | | $16.23 | $19.70 | $31.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.39 / $20.14 / $30.17
| Professional | | $16.39 | $20.14 | $30.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.57 / $16.57 / $17.35
| Facility | | $16.57 | $16.57 | $17.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.76 / $462.63 / $570.04
| Facility | | $32.76 | $462.63 | $570.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.02 / $28.95 / $55.19
| Professional | | $19.02 | $28.95 | $55.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.51 / $200.00 / $200.00
| Facility | | $43.51 | $200.00 | $200.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.00 / $200.00 / $200.00
| Professional | | $200.00 | $200.00 | $200.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.53 / $22.34 / $43.83
| Facility | | $17.53 | $22.34 | $43.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.92 / $24.91 / $33.09
| Professional | | $19.92 | $24.91 | $33.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.48 / $18.41 / $32.43
| Professional | | $16.48 | $18.41 | $32.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.53 / $22.68 / $46.02
| Facility | | $17.53 | $22.68 | $46.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.52 / $32.72 / $54.67
| Professional | | $19.52 | $32.72 | $54.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.88 / $26.42 / $43.86
| Professional | | $15.88 | $26.42 | $43.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.18 / $17.53 / $24.08
| Professional | | $15.18 | $17.53 | $24.08 |