- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $81.28 / $181.97
| Facility | | $19.05 | $81.28 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $12.30 / $40.74
| Professional | | $10.00 | $12.30 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $9.55 / $19.05
| Professional | | $5.75 | $9.55 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $47.86
| Facility | | $22.91 | $22.91 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.17 / $8.91 / $12.30
| Professional | | $6.17 | $8.91 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $19.95 / $35.48
| Facility | | $8.91 | $19.95 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $10.00 / $30.20
| Professional | | $8.71 | $10.00 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $19.05 / $25.12
| Professional | | $11.22 | $19.05 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $11.75 / $26.92
| Facility | | $10.96 | $11.75 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $19.95 / $21.88
| Professional | | $10.96 | $19.95 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $549.54
| Facility | | $234.42 | $234.42 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $13.49 / $23.99
| Facility | | $7.08 | $13.49 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $9.55 / $19.05
| Professional | | $6.76 | $9.55 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $64.57 / $100.00
| Facility | | $64.57 | $64.57 | $100.00 |