- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.80 / $98.78 / $165.36
| Facility | | $18.80 | $98.78 | $165.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.29 / $13.45 / $22.57
| Professional | | $11.29 | $13.45 | $22.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.53 / $7.53 / $11.04
| Professional | | $7.53 | $7.53 | $11.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.05 / $15.80 / $69.47
| Facility | | $15.05 | $15.80 | $69.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $9.52 / $21.12
| Professional | | $6.00 | $9.52 | $21.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.78 / $31.56 / $84.63
| Facility | | $19.78 | $31.56 | $84.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.68 / $15.10 / $22.26
| Professional | | $8.68 | $15.10 | $22.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.55 / $26.48 / $100.00
| Facility | | $13.55 | $26.48 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.53 / $12.80 / $22.00
| Professional | | $7.53 | $12.80 | $22.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.53 / $14.45 / $22.47
| Professional | | $7.53 | $14.45 | $22.47 |