- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.46 / $15.21 / $24.61
| Professional | | $9.46 | $15.21 | $24.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.86 / $44.24 / $49.16
| Facility | | $36.86 | $44.24 | $49.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.30 / $10.49 / $39.22
| Professional | | $8.30 | $10.49 | $39.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $20.48 / $20.48
| Facility | | $19.05 | $20.48 | $20.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.48 / $20.48 / $20.48
| Professional | | $20.48 | $20.48 | $20.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.79 / $35.79 / $35.79
| Facility | | $35.79 | $35.79 | $35.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.00 / $11.00 / $11.00
| Professional | | $11.00 | $11.00 | $11.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.81 / $33.18 / $53.34
| Professional | | $25.81 | $33.18 | $53.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.07 / $14.07 / $14.07
| Facility | | $14.07 | $14.07 | $14.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.07 / $14.07 / $14.07
| Professional | | $14.07 | $14.07 | $14.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.79 / $555.00 / $597.00
| Facility | | $35.79 | $555.00 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.00 / $11.00 / $42.52
| Professional | | $11.00 | $11.00 | $42.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.18 / $12.26 / $22.48
| Professional | | $8.18 | $12.26 | $22.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.07 / $15.36 / $24.58
| Professional | | $14.07 | $15.36 | $24.58 |