- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.45 / $57.35 / $276.94
| Facility | | $12.45 | $57.35 | $276.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.09 / $24.74 / $40.00
| Professional | | $10.09 | $24.74 | $40.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.59 / $26.58 / $8,639.91
| Facility | | $22.59 | $26.58 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.42 / $25.42 / $25.42
| Professional | | $25.42 | $25.42 | $25.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.11 / $24.50 / $24.50
| Facility | | $23.11 | $24.50 | $24.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.50 / $24.50 / $24.50
| Professional | | $24.50 | $24.50 | $24.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.00 / $49.18 / $69.64
| Facility | | $12.00 | $49.18 | $69.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.50 / $60.14 / $326.80
| Facility | | $24.50 | $60.14 | $326.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.00 / $24.75 / $74.51
| Professional | | $13.00 | $24.75 | $74.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.11 / $24.50 / $24.50
| Facility | | $23.11 | $24.50 | $24.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.50 / $24.50 / $24.50
| Professional | | $24.50 | $24.50 | $24.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.19 / $4.19 / $4.86
| Facility | | $4.19 | $4.19 | $4.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.19 / $4.19 / $4.86
| Professional | | $4.19 | $4.19 | $4.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.50 / $24.50 / $33.83
| Professional | | $24.50 | $24.50 | $33.83 |