- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.87 / $14.87 / $17.29
| Facility | | $14.87 | $14.87 | $17.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.54 / $17.29 / $30.07
| Professional | | $12.54 | $17.29 | $30.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.94 / $104.48 / $187.96
| Facility | | $27.94 | $104.48 | $187.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.78 / $32.84 / $209.94
| Professional | | $16.78 | $32.84 | $209.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.70 / $308.70 / $916.87
| Facility | | $308.70 | $308.70 | $916.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.17 / $25.17 / $54.00
| Facility | | $25.17 | $25.17 | $54.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.39 / $21.39 / $48.50
| Professional | | $21.39 | $21.39 | $48.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.61 / $26.61 / $26.61
| Professional | | $26.61 | $26.61 | $26.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.27 / $32.27 / $32.27
| Professional | | $32.27 | $32.27 | $32.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.16 / $21.16 / $21.16
| Professional | | $21.16 | $21.16 | $21.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $183.45 / $187.96
| Facility | | $85.00 | $183.45 | $187.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.46 / $23.74 / $338.10
| Professional | | $15.46 | $23.74 | $338.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.46 / $19.73 / $37.29
| Professional | | $15.46 | $19.73 | $37.29 |