- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $19.05 / $125.89
| Professional | | $12.02 | $19.05 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.19 / $2.19 / $2.19
| Facility | | $2.19 | $2.19 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $27.54 / $69.18
| Professional | | $15.14 | $27.54 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $46.77 / $61.66
| Facility | | $46.77 | $46.77 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $20.89 / $123.03
| Professional | | $17.38 | $20.89 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $35.48
| Facility | | $22.91 | $22.91 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.50 / $22.91 / $41.69
| Professional | | $19.50 | $22.91 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $26.92 / $31.62
| Professional | | $26.92 | $26.92 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.99 / $27.54 / $47.86
| Professional | | $23.99 | $27.54 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $162.18 / $162.18
| Facility | | $162.18 | $162.18 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $22.91 / $40.74
| Facility | | $10.96 | $22.91 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.50 / $22.91 / $27.54
| Professional | | $19.50 | $22.91 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $64.57 / $64.57
| Professional | | $64.57 | $64.57 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $26.92 / $27.54
| Professional | | $26.92 | $26.92 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.05 / $10.23 / $20.89
| Facility | | $1.05 | $10.23 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $16.22 / $34.67
| Professional | | $12.59 | $16.22 | $34.67 |