- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.15 / $7.25 / $145.37
| Facility | | $6.15 | $7.25 | $145.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.15 / $10.72 / $66.28
| Professional | | $6.15 | $10.72 | $66.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.45 / $8.86 / $15.00
| Facility | | $7.45 | $8.86 | $15.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.19 / $10.19 / $21.37
| Professional | | $10.19 | $10.19 | $21.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.11 / $33.85 / $48.54
| Facility | | $24.11 | $33.85 | $48.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.72 / $58.06 / $86.39
| Professional | | $26.72 | $58.06 | $86.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.73 / $11.73 / $11.73
| Professional | | $11.73 | $11.73 | $11.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.98 / $25.28 / $31.02
| Professional | | $22.98 | $25.28 | $31.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.00 / $28.73 / $54.00
| Professional | | $12.00 | $28.73 | $54.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.65 / $108.15 / $109.16
| Facility | | $46.65 | $108.15 | $109.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.44 / $114.44 / $220.93
| Professional | | $114.44 | $114.44 | $220.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.44 / $22.98 / $31.48
| Facility | | $16.44 | $22.98 | $31.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.73 / $11.73 / $24.57
| Professional | | $11.73 | $11.73 | $24.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.35 / $43.35 / $43.35
| Professional | | $43.35 | $43.35 | $43.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $18.04 / $38.75
| Professional | | $11.22 | $18.04 | $38.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.00 / $10.36 / $29.89
| Professional | | $9.00 | $10.36 | $29.89 |