- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.59 / $26.50 / $166.66
| Professional | | $18.59 | $26.50 | $166.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.04 / $3.37 / $98.88
| Facility | | $3.04 | $3.37 | $98.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.69 / $44.66 / $68.45
| Professional | | $33.69 | $44.66 | $68.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.83 / $71.83 / $71.83
| Facility | | $71.83 | $71.83 | $71.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.22 / $36.15 / $59.81
| Professional | | $31.22 | $36.15 | $59.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.90 / $37.90 / $48.19
| Facility | | $37.90 | $37.90 | $48.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.22 / $37.90 / $67.13
| Professional | | $32.22 | $37.90 | $67.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.19 / $48.19 / $57.83
| Professional | | $48.19 | $48.19 | $57.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.59 / $41.52 / $80.06
| Professional | | $35.59 | $41.52 | $80.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.03 / $272.00 / $275.26
| Facility | | $90.03 | $272.00 | $275.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.27 / $37.90 / $60.66
| Facility | | $19.27 | $37.90 | $60.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.22 / $37.90 / $41.73
| Professional | | $32.22 | $37.90 | $41.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.02 / $109.02 / $109.02
| Professional | | $109.02 | $109.02 | $109.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.36 / $46.36 / $48.19
| Professional | | $46.36 | $46.36 | $48.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.42 / $28.82 / $42.39
| Professional | | $23.42 | $28.82 | $42.39 |