- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.77 / $21.72 / $108.00
| Facility | | $10.77 | $21.72 | $108.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.62 / $16.63 / $23.00
| Professional | | $13.62 | $16.63 | $23.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.49 / $35.11 / $89.11
| Facility | | $21.49 | $35.11 | $89.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.20 / $19.30 / $29.75
| Professional | | $17.20 | $19.30 | $29.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.32 / $29.92 / $29.92
| Facility | | $19.32 | $29.92 | $29.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.00 / $65.00 / $70.00
| Facility | | $65.00 | $65.00 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.97 / $17.05 / $42.11
| Professional | | $12.97 | $17.05 | $42.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.92 / $108.63 / $108.63
| Facility | | $99.92 | $108.63 | $108.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.72 / $175.65 / $178.43
| Professional | | $142.72 | $175.65 | $178.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.67 / $19.22 / $25.40
| Facility | | $13.67 | $19.22 | $25.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.94 / $28.17 / $39.71
| Professional | | $22.94 | $28.17 | $39.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.69 / $26.23 / $49.23
| Professional | | $23.69 | $26.23 | $49.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.67 / $19.22 / $25.56
| Facility | | $13.67 | $19.22 | $25.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.21 / $20.66 / $55.83
| Professional | | $15.21 | $20.66 | $55.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.58 / $24.58 / $24.58
| Facility | | $24.58 | $24.58 | $24.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.38 / $20.86 / $30.58
| Professional | | $18.38 | $20.86 | $30.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.48 / $21.81 / $29.92
| Professional | | $18.48 | $21.81 | $29.92 |