- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.53 / $57.48 / $571.61
| Facility | | $21.53 | $57.48 | $571.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.53 / $21.74 / $33.52
| Professional | | $21.53 | $21.74 | $33.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.56 / $21.56 / $21.56
| Professional | | $21.56 | $21.56 | $21.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.93 / $23.35 / $8,459.92
| Facility | | $19.93 | $23.35 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.34 / $22.34 / $22.34
| Professional | | $22.34 | $22.34 | $22.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.30 / $21.52 / $21.52
| Facility | | $20.30 | $21.52 | $21.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.52 / $21.52 / $23.29
| Professional | | $21.52 | $21.52 | $23.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.34 / $23.35 / $32.32
| Professional | | $22.34 | $23.35 | $32.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.52 / $152.28 / $1,502.69
| Facility | | $81.52 | $152.28 | $1,502.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.11 / $55.18 / $571.61
| Facility | | $21.11 | $55.18 | $571.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.11 / $21.74 / $51.41
| Professional | | $21.11 | $21.74 | $51.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.40 / $37.60 / $60.30
| Professional | | $27.40 | $37.60 | $60.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.30 / $21.52 / $21.52
| Facility | | $20.30 | $21.52 | $21.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.52 / $21.52 / $24.37
| Professional | | $21.52 | $21.52 | $24.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.25 / $25.25 / $29.29
| Facility | | $25.25 | $25.25 | $29.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.25 / $25.25 / $29.29
| Professional | | $25.25 | $25.25 | $29.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.53 / $22.82 / $78.20
| Professional | | $21.53 | $22.82 | $78.20 |