- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.32 / $4.32 / $93.08
| Professional | | $4.32 | $4.32 | $93.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.06 / $55.99 / $58.19
| Facility | | $24.06 | $55.99 | $58.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $22.91
| Professional | | $22.91 | $22.91 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.25 / $50.55 / $77.54
| Facility | | $43.25 | $50.55 | $77.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.82 / $64.30 / $73.06
| Professional | | $19.82 | $64.30 | $73.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.07 / $16.07 / $29.32
| Facility | | $16.07 | $16.07 | $29.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.61 / $16.07 / $112.04
| Facility | | $7.61 | $16.07 | $112.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.81 / $19.34 / $43.93
| Professional | | $11.81 | $19.34 | $43.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.35 / $85.00 / $3,000.00
| Professional | | $59.35 | $85.00 | $3,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.07 / $16.07 / $29.32
| Facility | | $16.07 | $16.07 | $29.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.32 / $56.98 / $80.05
| Professional | | $32.32 | $56.98 | $80.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.88 / $50.00 / $112.04
| Facility | | $45.88 | $50.00 | $112.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.84 / $10.84 / $10.84
| Professional | | $10.84 | $10.84 | $10.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.84 / $10.84 / $10.84
| Professional | | $10.84 | $10.84 | $10.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.81 / $18.36 / $42.55
| Professional | | $11.81 | $18.36 | $42.55 |