- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.75 / $19.37 / $71.40
| Professional | | $15.75 | $19.37 | $71.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.70 / $1.88 / $1.88
| Facility | | $1.70 | $1.88 | $1.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.76 / $35.60 / $46.57
| Professional | | $18.76 | $35.60 | $46.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.34 / $34.72 / $71.61
| Professional | | $26.34 | $34.72 | $71.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.82 / $19.82 / $50.32
| Facility | | $19.82 | $19.82 | $50.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.86 / $19.82 / $33.38
| Professional | | $16.86 | $19.82 | $33.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.86 / $30.86 / $37.03
| Professional | | $30.86 | $30.86 | $37.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.73 / $26.52 / $51.14
| Professional | | $22.73 | $26.52 | $51.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $142.13 / $142.13
| Facility | | $75.00 | $142.13 | $142.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.34 / $23.40 / $43.71
| Facility | | $16.34 | $23.40 | $43.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.86 / $19.82 / $26.55
| Professional | | $16.86 | $19.82 | $26.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.08 / $59.08 / $59.08
| Professional | | $59.08 | $59.08 | $59.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.18 / $22.18 / $30.86
| Professional | | $22.18 | $22.18 | $30.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.35 / $18.14 / $32.03
| Professional | | $15.35 | $18.14 | $32.03 |