- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.63 / $66.28 / $236.40
| Facility | | $10.63 | $66.28 | $236.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.35 / $7.42 / $8.47
| Professional | | $7.35 | $7.42 | $8.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.28 / $14.12 / $30.88
| Facility | | $4.28 | $14.12 | $30.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.08 / $3.08 / $3.08
| Professional | | $3.08 | $3.08 | $3.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.01 / $23.21 / $56.34
| Facility | | $4.01 | $23.21 | $56.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.52 / $24.52 / $24.52
| Facility | | $24.52 | $24.52 | $24.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.93 / $7.35 / $7.35
| Facility | | $6.93 | $7.35 | $7.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.35 / $7.35 / $7.35
| Professional | | $7.35 | $7.35 | $7.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $100.00 / $100.00
| Facility | | $85.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.05 / $10.93 / $100.64
| Facility | | $1.05 | $10.93 | $100.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.63 / $7.35 / $15.48
| Professional | | $4.63 | $7.35 | $15.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.44 / $537.76 / $2,838.00
| Facility | | $319.44 | $537.76 | $2,838.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.13 / $7.35 / $10.51
| Facility | | $1.13 | $7.35 | $10.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.03 / $7.35 / $13.48
| Professional | | $7.03 | $7.35 | $13.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.35 / $7.35 / $7.35
| Professional | | $7.35 | $7.35 | $7.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.17 / $8.55 / $9.92
| Professional | | $6.17 | $8.55 | $9.92 |