- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.19 / $13.75 / $16.86
| Facility | | $11.19 | $13.75 | $16.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.65 / $17.98 / $27.63
| Professional | | $12.65 | $17.98 | $27.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.88 / $12.73 / $14.98
| Professional | | $5.88 | $12.73 | $14.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.42 / $18.42 / $19.34
| Facility | | $18.42 | $18.42 | $19.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.19 / $601.19 / $601.19
| Facility | | $601.19 | $601.19 | $601.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.64 / $19.64 / $19.64
| Professional | | $19.64 | $19.64 | $19.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.72 / $131.60 / $169.20
| Facility | | $40.72 | $131.60 | $169.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.85 / $119.45 / $186.08
| Professional | | $114.85 | $119.45 | $186.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.67 / $24.04 / $34.81
| Facility | | $16.67 | $24.04 | $34.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.55 / $29.89 / $39.71
| Professional | | $24.55 | $29.89 | $39.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.67 / $15.58 / $32.70
| Professional | | $8.67 | $15.58 | $32.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.86 / $23.95 / $36.35
| Facility | | $16.86 | $23.95 | $36.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.64 / $19.64 / $38.47
| Professional | | $19.64 | $19.64 | $38.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.30 / $20.26 / $31.25
| Professional | | $15.30 | $20.26 | $31.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.22 / $20.47 / $28.88
| Professional | | $18.22 | $20.47 | $28.88 |