- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.08 / $41.25 / $71.25
| Facility | | $21.08 | $41.25 | $71.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.35 / $7.66 / $21.25
| Professional | | $7.35 | $7.66 | $21.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.00 / $25.00 / $65.00
| Facility | | $25.00 | $25.00 | $65.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.72 / $10.00 / $34.49
| Professional | | $4.72 | $10.00 | $34.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.00 / $25.00 / $25.00
| Facility | | $25.00 | $25.00 | $25.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.25 / $25.00 / $25.00
| Professional | | $18.25 | $25.00 | $25.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.32 / $50.89 / $65.20
| Facility | | $13.32 | $50.89 | $65.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.60 / $13.15 / $32.34
| Professional | | $7.60 | $13.15 | $32.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.00 / $32.50 / $332.00
| Facility | | $9.00 | $32.50 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $14.75 / $46.75
| Professional | | $10.00 | $14.75 | $46.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $18.64 / $32.50
| Professional | | $8.94 | $18.64 | $32.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.66 / $52.81 / $87.59
| Facility | | $16.66 | $52.81 | $87.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.15 / $16.25 / $38.75
| Professional | | $13.15 | $16.25 | $38.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.25 / $15.00 / $36.25
| Professional | | $11.25 | $15.00 | $36.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.00 / $28.75 / $28.75
| Facility | | $25.00 | $28.75 | $28.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $13.14 / $30.05
| Professional | | $8.94 | $13.14 | $30.05 |