- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.30 / $36.60 / $83.27
| Facility | | $18.30 | $36.60 | $83.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.30 / $18.48 / $547.65
| Professional | | $18.30 | $18.48 | $547.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.76 / $29.23 / $65.52
| Facility | | $18.76 | $29.23 | $65.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.21 / $18.30 / $51.33
| Professional | | $18.21 | $18.30 | $51.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.49 / $22.69 / $41.42
| Facility | | $21.49 | $22.69 | $41.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.64 / $18.64 / $51.29
| Professional | | $18.64 | $18.64 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.26 / $17.26 / $18.30
| Facility | | $17.26 | $17.26 | $18.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.30 / $18.30 / $18.30
| Professional | | $18.30 | $18.30 | $18.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.47 / $21.96 / $41.47
| Professional | | $16.47 | $21.96 | $41.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $91.00 / $91.50
| Facility | | $75.00 | $91.00 | $91.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.26 / $18.30 / $26.17
| Facility | | $17.26 | $18.30 | $26.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.30 / $18.30 / $39.58
| Professional | | $18.30 | $18.30 | $39.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.40 / $32.40 / $32.40
| Professional | | $32.40 | $32.40 | $32.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.64 / $20.13 / $31.10
| Professional | | $14.64 | $20.13 | $31.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.30 / $18.30 / $45.12
| Professional | | $18.30 | $18.30 | $45.12 |