- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.75 / $81.06 / $194.40
| Facility | | $32.75 | $81.06 | $194.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.43 / $18.19 / $25.76
| Professional | | $15.43 | $18.19 | $25.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.03 / $36.29 / $100.00
| Facility | | $19.03 | $36.29 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.52 / $20.86 / $50.81
| Professional | | $12.52 | $20.86 | $50.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.52 / $58.16 / $101.68
| Facility | | $36.52 | $58.16 | $101.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.61 / $19.61 / $26.69
| Professional | | $19.61 | $19.61 | $26.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.58 / $31.00 / $71.28
| Facility | | $14.58 | $31.00 | $71.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.49 / $23.95 / $62.05
| Professional | | $12.49 | $23.95 | $62.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.87 / $29.87 / $35.14
| Professional | | $29.87 | $29.87 | $35.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.86 / $28.91 / $77.65
| Professional | | $20.86 | $28.91 | $77.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.05 / $27.19 / $202.95
| Facility | | $23.05 | $27.19 | $202.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.29 / $100.00 / $100.00
| Facility | | $36.29 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.01 / $12.60 / $49.74
| Professional | | $10.01 | $12.60 | $49.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.28 / $23.67 / $34.00
| Facility | | $21.28 | $23.67 | $34.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.39 / $21.52 / $26.39
| Professional | | $18.39 | $21.52 | $26.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.01 / $12.60 / $78.33
| Professional | | $10.01 | $12.60 | $78.33 |