- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.08 / $24.91 / $42.15
| Facility | | $21.08 | $24.91 | $42.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.73 / $26.06 / $41.39
| Professional | | $19.73 | $26.06 | $41.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.86 / $332.83 / $551.29
| Professional | | $52.86 | $332.83 | $551.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.18 / $47.18 / $47.18
| Facility | | $47.18 | $47.18 | $47.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.44 / $32.44 / $32.44
| Professional | | $32.44 | $32.44 | $32.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.26 / $73.68 / $332.00
| Facility | | $40.26 | $73.68 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.27 / $54.51 / $87.36
| Professional | | $42.27 | $54.51 | $87.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.77 / $31.77 / $31.77
| Facility | | $31.77 | $31.77 | $31.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.77 / $33.75 / $35.25
| Professional | | $31.77 | $33.75 | $35.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.18 / $47.18 / $597.00
| Facility | | $47.18 | $47.18 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.74 / $32.44 / $78.94
| Professional | | $28.74 | $32.44 | $78.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.10 / $24.16 / $46.81
| Professional | | $14.10 | $24.16 | $46.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.77 / $31.77 / $31.77
| Facility | | $31.77 | $31.77 | $31.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.77 / $31.77 / $33.75
| Professional | | $31.77 | $31.77 | $33.75 |