- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.57 / $23.34 / $39.86
| Facility | | $16.57 | $23.34 | $39.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.57 / $23.34 / $36.01
| Professional | | $16.57 | $23.34 | $36.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.89 / $16.89 / $61.08
| Professional | | $16.89 | $16.89 | $61.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.50 / $31.72 / $31.72
| Facility | | $29.50 | $31.72 | $31.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.72 / $31.72 / $31.72
| Professional | | $31.72 | $31.72 | $31.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.62 / $44.62 / $44.62
| Facility | | $44.62 | $44.62 | $44.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.44 / $19.44 / $19.44
| Professional | | $19.44 | $19.44 | $19.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.07 / $69.67 / $332.00
| Facility | | $38.07 | $69.67 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.07 / $51.39 / $82.61
| Professional | | $38.07 | $51.39 | $82.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.02 / $14.02 / $22.02
| Facility | | $14.02 | $14.02 | $22.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.02 / $22.02 / $23.39
| Professional | | $14.02 | $22.02 | $23.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.62 / $44.62 / $597.00
| Facility | | $44.62 | $44.62 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.44 / $19.44 / $65.22
| Professional | | $19.44 | $19.44 | $65.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.66 / $22.84 / $47.24
| Professional | | $12.66 | $22.84 | $47.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.02 / $22.02 / $27.25
| Facility | | $22.02 | $22.02 | $27.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.02 / $22.02 / $23.39
| Professional | | $14.02 | $22.02 | $23.39 |