- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.68 / $77.84 / $211.25
| Facility | | $48.68 | $77.84 | $211.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.41 / $22.45 / $60.23
| Professional | | $16.41 | $22.45 | $60.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $39.40 / $76.83
| Facility | | $30.20 | $39.40 | $76.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.19 / $38.38 / $41.40
| Professional | | $19.19 | $38.38 | $41.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.00 / $149.00 / $149.00
| Facility | | $149.00 | $149.00 | $149.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.91 / $36.14 / $57.12
| Professional | | $28.91 | $36.14 | $57.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.15 / $49.11 / $120.30
| Facility | | $15.15 | $49.11 | $120.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.99 / $15.15 / $63.00
| Professional | | $14.99 | $15.15 | $63.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.92 / $40.69 / $79.16
| Facility | | $30.92 | $40.69 | $79.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.33 / $53.73 / $72.73
| Professional | | $30.33 | $53.73 | $72.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.25 / $25.25 / $33.67
| Facility | | $25.25 | $25.25 | $33.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.39 / $15.15 / $27.78
| Professional | | $14.39 | $15.15 | $27.78 |