- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.93 / $9.93 / $9.93
| Facility | | $9.93 | $9.93 | $9.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.02 / $11.06 / $47.00
| Professional | | $8.02 | $11.06 | $47.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.88 / $66.88 / $237.51
| Facility | | $66.88 | $66.88 | $237.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.64 / $27.95 / $329.00
| Professional | | $11.64 | $27.95 | $329.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.06 / $31.84 / $33.36
| Facility | | $28.06 | $31.84 | $33.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.93 / $21.99 / $29.34
| Professional | | $13.93 | $21.99 | $29.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.44 / $24.14 / $99.29
| Professional | | $11.44 | $24.14 | $99.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.12 / $14.80 / $14.80
| Facility | | $13.12 | $14.80 | $14.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.12 / $13.12 / $14.80
| Professional | | $13.12 | $13.12 | $14.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.19 / $24.48 / $35.72
| Professional | | $12.19 | $24.48 | $35.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.96 / $16.45 / $35.79
| Professional | | $13.96 | $16.45 | $35.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.88 / $66.88 / $237.51
| Facility | | $66.88 | $66.88 | $237.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.35 / $40.27 / $329.00
| Professional | | $11.35 | $40.27 | $329.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.73 / $10.27 / $12.79
| Facility | | $9.73 | $10.27 | $12.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.73 / $13.60 / $24.41
| Professional | | $9.73 | $13.60 | $24.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.28 / $18.44 / $50.20
| Professional | | $10.28 | $18.44 | $50.20 |