- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.23 / $88.53 / $1,315.38
| Facility | | $20.23 | $88.53 | $1,315.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.83 / $15.07 / $20.23
| Professional | | $13.83 | $15.07 | $20.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.27 / $43.86 / $46.39
| Facility | | $36.27 | $43.86 | $46.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.33 / $8.33 / $68.81
| Professional | | $8.33 | $8.33 | $68.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.51 / $45.80 / $47.60
| Facility | | $11.51 | $45.80 | $47.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.86 / $54.76 / $84.00
| Facility | | $46.86 | $54.76 | $84.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.41 / $45.43 / $51.63
| Professional | | $19.41 | $45.43 | $51.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.02 / $15.02 / $20.23
| Facility | | $15.02 | $15.02 | $20.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.83 / $15.18 / $341.00
| Facility | | $13.83 | $15.18 | $341.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.11 / $16.87 / $42.27
| Professional | | $10.11 | $16.87 | $42.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.44 / $28.25 / $85.00
| Professional | | $8.44 | $28.25 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.02 / $15.02 / $20.23
| Facility | | $15.02 | $15.02 | $20.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.61 / $41.18 / $71.40
| Professional | | $20.61 | $41.18 | $71.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.74 / $33.74 / $341.00
| Facility | | $33.74 | $33.74 | $341.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $11.11 / $16.47
| Professional | | $8.94 | $11.11 | $16.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.93 / $35.93 / $169.07
| Professional | | $35.93 | $35.93 | $169.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.46 / $169.07 / $169.07
| Professional | | $57.46 | $169.07 | $169.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $13.50 / $42.27
| Professional | | $9.77 | $13.50 | $42.27 |