- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.02 / $22.45 / $22.89
| Facility | | $22.02 | $22.45 | $22.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.73 / $22.89 / $37.13
| Professional | | $20.73 | $22.89 | $37.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.47 / $23.47 / $29.36
| Professional | | $23.47 | $23.47 | $29.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.32 / $49.32 / $49.32
| Facility | | $49.32 | $49.32 | $49.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.72 / $33.72 / $33.72
| Facility | | $33.72 | $33.72 | $33.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.62 / $24.62 / $33.72
| Professional | | $24.62 | $24.62 | $33.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $228.34 / $228.34
| Facility | | $85.00 | $228.34 | $228.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.66 / $246.66 / $359.03
| Professional | | $246.66 | $246.66 | $359.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.11 / $37.03 / $49.32
| Facility | | $14.11 | $37.03 | $49.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.11 / $41.92 / $49.32
| Professional | | $14.11 | $41.92 | $49.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.99 / $50.31 / $110.97
| Professional | | $36.99 | $50.31 | $110.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.11 / $33.72 / $49.32
| Facility | | $14.11 | $33.72 | $49.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.62 / $24.62 / $35.95
| Professional | | $24.62 | $24.62 | $35.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.65 / $49.65 / $58.41
| Facility | | $49.65 | $49.65 | $58.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.22 / $26.35 / $31.36
| Professional | | $18.22 | $26.35 | $31.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.95 / $26.27 / $49.32
| Professional | | $25.95 | $26.27 | $49.32 |