- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $114.82 / $380.19
| Facility | | $29.51 | $114.82 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $22.39 / $51.29
| Professional | | $18.20 | $22.39 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.44 / $36.31 / $123.03
| Facility | | $23.44 | $36.31 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $25.70 / $54.95
| Professional | | $11.48 | $25.70 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $63.10 / $100.00
| Facility | | $50.12 | $63.10 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.99 / $23.99 / $32.36
| Professional | | $23.99 | $23.99 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.95 / $40.74 / $100.00
| Facility | | $19.95 | $40.74 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.62 / $31.62 / $43.65
| Professional | | $18.62 | $31.62 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $3,630.78 / $9,772.37
| Facility | | $36.31 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $37.15 / $43.65
| Professional | | $37.15 | $37.15 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $25.70 / $77.62
| Professional | | $25.70 | $25.70 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $33.88 / $208.93
| Facility | | $30.20 | $33.88 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.44 / $36.31 / $123.03
| Facility | | $23.44 | $36.31 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $25.70 / $54.95
| Professional | | $12.30 | $25.70 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.91 / $29.51 / $58.88
| Facility | | $22.91 | $29.51 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $26.92 / $38.90
| Professional | | $22.91 | $26.92 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.79 / $25.70 / $43.65
| Facility | | $14.79 | $25.70 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $21.88 / $61.66
| Professional | | $11.48 | $21.88 | $61.66 |