- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.86 / $19.52 / $33.35
| Facility | | $13.86 | $19.52 | $33.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.86 / $19.52 / $30.12
| Professional | | $13.86 | $19.52 | $30.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.69 / $14.13 / $45.47
| Professional | | $10.69 | $14.13 | $45.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.68 / $26.54 / $26.54
| Facility | | $24.68 | $26.54 | $26.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.54 / $26.54 / $26.54
| Professional | | $26.54 | $26.54 | $26.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.33 / $37.33 / $37.33
| Facility | | $37.33 | $37.33 | $37.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.27 / $16.27 / $16.27
| Professional | | $16.27 | $16.27 | $16.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.86 / $58.30 / $332.00
| Facility | | $31.86 | $58.30 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.41 / $43.01 / $69.14
| Professional | | $18.41 | $43.01 | $69.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.27 / $8.27 / $18.41
| Facility | | $8.27 | $8.27 | $18.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.27 / $18.41 / $19.55
| Professional | | $8.27 | $18.41 | $19.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.33 / $37.33 / $597.00
| Facility | | $37.33 | $37.33 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.27 / $16.27 / $54.57
| Professional | | $16.27 | $16.27 | $54.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $19.12 / $39.52
| Professional | | $10.60 | $19.12 | $39.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.41 / $18.41 / $19.37
| Facility | | $18.41 | $18.41 | $19.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.27 / $18.41 / $19.55
| Professional | | $8.27 | $18.41 | $19.55 |