- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.77 / $76.75 / $217.27
| Facility | | $12.77 | $76.75 | $217.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.92 / $15.73 / $116.13
| Professional | | $11.92 | $15.73 | $116.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.95 / $58.64 / $114.35
| Facility | | $44.95 | $58.64 | $114.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.73 / $27.44 / $29.62
| Professional | | $13.73 | $27.44 | $29.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.65 / $25.81 / $40.79
| Professional | | $20.65 | $25.81 | $40.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.84 / $24.86 / $135.00
| Facility | | $10.84 | $24.86 | $135.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.84 / $10.84 / $52.38
| Professional | | $10.84 | $10.84 | $52.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.12 / $36.78 / $56.62
| Facility | | $22.12 | $36.78 | $56.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.67 / $39.58 / $52.02
| Professional | | $21.67 | $39.58 | $52.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.29 / $10.84 / $36.11
| Professional | | $10.29 | $10.84 | $36.11 |