- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.78 / $18.00 / $30.76
| Facility | | $12.78 | $18.00 | $30.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.22 / $16.64 / $27.78
| Professional | | $10.22 | $16.64 | $27.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.03 / $13.03 / $47.12
| Professional | | $13.03 | $13.03 | $47.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.76 / $24.47 / $24.47
| Facility | | $22.76 | $24.47 | $24.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.47 / $24.47 / $24.47
| Professional | | $24.47 | $24.47 | $24.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.43 / $34.43 / $34.43
| Facility | | $34.43 | $34.43 | $34.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $15.00 / $15.00
| Professional | | $15.00 | $15.00 | $15.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.38 / $53.77 / $332.00
| Facility | | $29.38 | $53.77 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.38 / $39.65 / $63.75
| Professional | | $29.38 | $39.65 | $63.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $20.07 / $20.07
| Facility | | $16.98 | $20.07 | $20.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $18.05 / $20.07
| Professional | | $16.98 | $18.05 | $20.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.43 / $34.43 / $597.00
| Facility | | $34.43 | $34.43 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $15.00 / $50.31
| Professional | | $15.00 | $15.00 | $50.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $17.63 / $31.75
| Professional | | $9.77 | $17.63 | $31.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $16.98 / $21.02
| Facility | | $16.98 | $16.98 | $21.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $18.05 / $20.07
| Professional | | $16.98 | $18.05 | $20.07 |