- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.05 / $96.75 / $287.82
| Facility | | $12.05 | $96.75 | $287.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.17 / $6.28 / $12.00
| Professional | | $5.17 | $6.28 | $12.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.13 / $5.38 / $10.33
| Professional | | $4.13 | $5.38 | $10.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.03 / $21.52 / $45.37
| Facility | | $6.03 | $21.52 | $45.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $5.50 / $7.66
| Professional | | $5.00 | $5.50 | $7.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.03 / $12.48 / $174.00
| Facility | | $6.03 | $12.48 | $174.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.17 / $8.61 / $13.86
| Professional | | $5.17 | $8.61 | $13.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.61 / $35.70 / $35.70
| Facility | | $8.61 | $35.70 | $35.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.02 / $14.46 / $37.51
| Facility | | $6.02 | $14.46 | $37.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.23 / $7.14 / $13.30
| Professional | | $4.23 | $7.14 | $13.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.33 / $60.00 / $60.00
| Facility | | $37.33 | $60.00 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.43 / $10.73 / $15.54
| Professional | | $7.43 | $10.73 | $15.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.37 / $8.61 / $245.70
| Facility | | $6.37 | $8.61 | $245.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.32 / $8.61 / $11.62
| Professional | | $7.32 | $8.61 | $11.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $898.08 / $1,459.38 / $2,220.73
| Facility | | $898.08 | $1,459.38 | $2,220.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.20 / $8.61 / $19.54
| Facility | | $6.20 | $8.61 | $19.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.23 / $7.20 / $10.89
| Professional | | $4.23 | $7.20 | $10.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.17 / $5.17 / $8.61
| Professional | | $5.17 | $5.17 | $8.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.44 / $3.44 / $8.61
| Professional | | $3.44 | $3.44 | $8.61 |