- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.37 / $40.78 / $90.58
| Facility | | $25.37 | $40.78 | $90.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.37 / $28.41 / $99.22
| Professional | | $25.37 | $28.41 | $99.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.37 / $25.37 / $91.54
| Professional | | $25.37 | $25.37 | $91.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.10 / $32.10 / $33.71
| Facility | | $32.10 | $32.10 | $33.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.10 / $32.10 / $32.10
| Professional | | $32.10 | $32.10 | $32.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.93 / $23.93 / $36.43
| Facility | | $23.93 | $23.93 | $36.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.37 / $25.37 / $25.37
| Professional | | $25.37 | $25.37 | $25.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.93 / $35.90 / $332.00
| Facility | | $23.93 | $35.90 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.52 / $27.52 / $66.53
| Professional | | $27.52 | $27.52 | $66.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.37 / $25.37 / $26.33
| Facility | | $25.37 | $25.37 | $26.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.37 / $25.37 / $26.33
| Professional | | $25.37 | $25.37 | $26.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.80 / $81.80 / $81.80
| Facility | | $81.80 | $81.80 | $81.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.93 / $23.93 / $555.00
| Facility | | $23.93 | $23.93 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.37 / $30.39 / $44.43
| Professional | | $25.37 | $30.39 | $44.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.37 / $25.37 / $47.26
| Professional | | $25.37 | $25.37 | $47.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.33 / $26.33 / $26.33
| Facility | | $26.33 | $26.33 | $26.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.37 / $26.33 / $96.09
| Professional | | $25.37 | $26.33 | $96.09 |