- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.30 / $35.29 / $95.15
| Facility | | $19.30 | $35.29 | $95.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.43 / $21.67 / $41.95
| Professional | | $15.43 | $21.67 | $41.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.22 / $17.22 / $61.04
| Professional | | $17.22 | $17.22 | $61.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.36 / $36.96 / $36.96
| Facility | | $34.36 | $36.96 | $36.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.96 / $36.96 / $36.96
| Professional | | $36.96 | $36.96 | $36.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.51 / $26.66 / $26.66
| Facility | | $22.51 | $26.66 | $26.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.66 / $22.66 / $31.36
| Professional | | $22.66 | $22.66 | $31.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.36 / $99.81 / $332.00
| Facility | | $44.36 | $99.81 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $37.26 / $81.18
| Professional | | $22.91 | $37.26 | $81.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.65 / $27.26 / $36.96
| Professional | | $25.65 | $27.26 | $36.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.51 / $26.66 / $555.00
| Facility | | $22.51 | $26.66 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.66 / $26.66 / $54.84
| Professional | | $22.66 | $26.66 | $54.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.76 / $22.38 / $40.58
| Professional | | $14.76 | $22.38 | $40.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.65 / $25.65 / $31.75
| Facility | | $25.65 | $25.65 | $31.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.65 / $25.65 / $27.26
| Professional | | $25.65 | $25.65 | $27.26 |