- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $44.94 / $131.24
| Facility | | $18.20 | $44.94 | $131.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.48 / $18.30 / $24.08
| Professional | | $13.48 | $18.30 | $24.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.05 / $16.72 / $16.72
| Professional | | $16.05 | $16.72 | $16.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.25 / $74.33 / $127.54
| Facility | | $26.25 | $74.33 | $127.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $12.76 / $14.93
| Professional | | $5.00 | $12.76 | $14.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.86 / $23.96 / $33.71
| Professional | | $16.86 | $23.96 | $33.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.08 / $24.08 / $24.08
| Facility | | $24.08 | $24.08 | $24.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.21 / $52.58 / $111.86
| Facility | | $14.21 | $52.58 | $111.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.66 / $12.66 / $31.41
| Professional | | $12.66 | $12.66 | $31.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $114.38 / $114.38
| Facility | | $75.00 | $114.38 | $114.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.30 / $24.08 / $29.38
| Facility | | $18.30 | $24.08 | $29.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.67 / $24.08 / $31.38
| Professional | | $21.67 | $24.08 | $31.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.26 / $39.15 / $54.89
| Facility | | $30.26 | $39.15 | $54.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.05 / $24.08 / $55.61
| Facility | | $18.05 | $24.08 | $55.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.66 / $18.54 / $33.69
| Professional | | $12.66 | $18.54 | $33.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.11 / $13.87 / $16.80
| Professional | | $10.11 | $13.87 | $16.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.89 / $11.89 / $24.08
| Professional | | $11.89 | $11.89 | $24.08 |