- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.01 / $13.01 / $77.83
| Facility | | $13.01 | $13.01 | $77.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.97 / $14.88 / $37.13
| Professional | | $10.97 | $14.88 | $37.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.11 / $29.82 / $138.41
| Facility | | $13.11 | $29.82 | $138.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.59 / $29.73 / $168.68
| Professional | | $15.59 | $29.73 | $168.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.11 / $45.43 / $47.60
| Facility | | $38.11 | $45.43 | $47.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.54 / $30.40 / $40.21
| Professional | | $23.54 | $30.40 | $40.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.71 / $17.71 / $17.71
| Facility | | $17.71 | $17.71 | $17.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.99 / $13.99 / $18.38
| Professional | | $13.99 | $13.99 | $18.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.00 / $16.00 / $20.39
| Facility | | $16.00 | $16.00 | $20.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.34 / $22.07 / $33.47
| Professional | | $17.34 | $22.07 | $33.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.25 / $38.15 / $48.86
| Professional | | $19.25 | $38.15 | $48.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.27 / $197.27 / $197.27
| Facility | | $197.27 | $197.27 | $197.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.00 / $20.00 / $25.00
| Professional | | $20.00 | $20.00 | $25.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.82 / $138.41 / $138.41
| Facility | | $29.82 | $138.41 | $138.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.14 / $29.26 / $168.68
| Professional | | $17.14 | $29.26 | $168.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.82 / $25.05 / $46.00
| Professional | | $16.82 | $25.05 | $46.00 |