- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.28 / $13.05 / $108.00
| Facility | | $10.28 | $13.05 | $108.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.44 / $15.25 / $20.95
| Professional | | $10.44 | $15.25 | $20.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.45 / $37.72 / $86.46
| Facility | | $19.45 | $37.72 | $86.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.56 / $18.43 / $18.43
| Professional | | $14.56 | $18.43 | $18.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.34 / $57.15 / $57.15
| Facility | | $18.34 | $57.15 | $57.15 |
- 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
- $12.49 / $16.30 / $41.25
| Professional | | $12.49 | $16.30 | $41.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $85.43 / $105.40
| Facility | | $80.00 | $85.43 | $105.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.29 / $138.46 / $170.48
| Professional | | $136.29 | $138.46 | $170.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.44 / $15.64 / $23.92
| Facility | | $10.44 | $15.64 | $23.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.77 / $26.91 / $49.50
| Professional | | $22.77 | $26.91 | $49.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.18 / $25.08 / $48.08
| Professional | | $22.18 | $25.08 | $48.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.44 / $15.64 / $24.15
| Facility | | $10.44 | $15.64 | $24.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.75 / $21.79 / $55.68
| Professional | | $14.75 | $21.79 | $55.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.98 / $19.94 / $31.69
| Professional | | $17.98 | $19.94 | $31.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.67 / $20.83 / $28.57
| Professional | | $17.67 | $20.83 | $28.57 |