- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.98 / $26.98 / $27.19
| Facility | | $26.98 | $26.98 | $27.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.04 / $26.98 / $36.19
| Professional | | $5.04 | $26.98 | $36.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.50 / $22.50 / $22.50
| Professional | | $22.50 | $22.50 | $22.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.00 / $9.00 / $15.00
| Professional | | $8.00 | $9.00 | $15.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.00 / $23.00 / $51.44
| Professional | | $19.00 | $23.00 | $51.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.00 / $70.00 / $85.00
| Facility | | $70.00 | $70.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.00 / $125.00 / $125.00
| Professional | | $125.00 | $125.00 | $125.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.17 / $26.98 / $35.07
| Facility | | $5.17 | $26.98 | $35.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.50 / $23.27 / $27.00
| Professional | | $22.50 | $23.27 | $27.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.82 / $23.82 / $32.32
| Professional | | $23.82 | $23.82 | $32.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.12 / $26.98 / $36.19
| Facility | | $5.12 | $26.98 | $36.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.00 / $21.60 / $27.00
| Professional | | $19.00 | $21.60 | $27.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.33 / $6.40 / $23.82
| Professional | | $4.33 | $6.40 | $23.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.90 / $21.90 / $30.66
| Professional | | $21.90 | $21.90 | $30.66 |