- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.49 / $10.64 / $245.10
| Facility | | $10.49 | $10.64 | $245.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $11.27 / $18.48
| Professional | | $9.77 | $11.27 | $18.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.34 / $13.34 / $13.34
| Professional | | $13.34 | $13.34 | $13.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.97 / $18.97 / $18.97
| Facility | | $18.97 | $18.97 | $18.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.60 / $6.60 / $6.60
| Professional | | $6.60 | $6.60 | $6.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.86 / $90.00 / $93.85
| Facility | | $32.86 | $90.00 | $93.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.43 / $217.33 / $226.02
| Professional | | $121.43 | $217.33 | $226.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.78 / $16.54 / $45.94
| Facility | | $10.78 | $16.54 | $45.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.76 / $15.38 / $16.19
| Professional | | $13.76 | $15.38 | $16.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.87 / $18.16 / $28.33
| Professional | | $15.87 | $18.16 | $28.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.94 / $17.48 / $45.94
| Facility | | $10.94 | $17.48 | $45.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.60 / $6.60 / $13.46
| Professional | | $6.60 | $6.60 | $13.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.72 / $7.34 / $11.12
| Professional | | $5.72 | $7.34 | $11.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.19 / $16.19 / $21.86
| Professional | | $16.19 | $16.19 | $21.86 |