- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.20 / $28.00 / $45.60
| Facility | | $15.20 | $28.00 | $45.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.72 / $10.52 / $13.60
| Professional | | $8.72 | $10.52 | $13.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.00 / $16.00 / $41.60
| Facility | | $16.00 | $16.00 | $41.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.92 / $5.92 / $20.39
| Professional | | $5.92 | $5.92 | $20.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.00 / $16.00 / $16.00
| Facility | | $16.00 | $16.00 | $16.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.68 / $16.00 / $16.00
| Professional | | $11.68 | $16.00 | $16.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.18 / $32.50 / $41.65
| Facility | | $11.18 | $32.50 | $41.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.17 / $22.72 / $77.12
| Professional | | $18.17 | $22.72 | $77.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.00 / $33.60 / $332.00
| Facility | | $16.00 | $33.60 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.40 / $9.44 / $29.92
| Professional | | $6.40 | $9.44 | $29.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.02 / $15.20 / $17.97
| Professional | | $10.02 | $15.20 | $17.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.60 / $33.79 / $42.85
| Facility | | $15.60 | $33.79 | $42.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.40 / $18.17 / $32.96
| Professional | | $10.40 | $18.17 | $32.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.72 / $9.60 / $23.20
| Professional | | $6.72 | $9.60 | $23.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.00 / $18.39 / $18.39
| Facility | | $16.00 | $18.39 | $18.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.02 / $16.00 / $19.23
| Professional | | $10.02 | $16.00 | $19.23 |