- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.62 / $51.29 / $100.00
| Facility | | $18.62 | $51.29 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $18.62 / $21.88
| Professional | | $7.94 | $18.62 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $19.50 / $34.67
| Facility | | $19.50 | $19.50 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $13.49 / $21.88
| Professional | | $6.46 | $13.49 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $25.70 / $30.90
| Professional | | $12.02 | $25.70 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $25.12 / $97.72
| Facility | | $12.02 | $25.12 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $13.80 / $19.95
| Professional | | $10.23 | $13.80 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $12.59 / $18.20
| Facility | | $12.02 | $12.59 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.22 / $16.60 / $35.48
| Facility | | $11.22 | $16.60 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $13.18 / $16.22
| Professional | | $11.22 | $13.18 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $36.31 / $47.86
| Facility | | $18.20 | $36.31 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $10.96 / $14.45
| Professional | | $8.71 | $10.96 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $19.50
| Facility | | $14.45 | $14.45 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.79 / $4.79 / $13.80
| Professional | | $4.79 | $4.79 | $13.80 |