- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $60.26 / $97.72
| Facility | | $30.20 | $60.26 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $22.91 / $100.00
| Professional | | $19.95 | $22.91 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $33.88 / $181.97
| Facility | | $21.88 | $33.88 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $26.30 / $61.66
| Professional | | $12.59 | $26.30 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $38.02 / $60.26
| Facility | | $30.20 | $38.02 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $28.18 / $29.51
| Professional | | $28.18 | $28.18 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $38.90 / $87.10
| Facility | | $20.89 | $38.90 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.55 / $36.31 / $85.11
| Professional | | $24.55 | $36.31 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $83.18 / $7,079.46
| Facility | | $30.20 | $83.18 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.89 / $33.11 / $53.70
| Professional | | $20.89 | $33.11 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $69.18
| Professional | | $30.20 | $30.20 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $33.88 / $181.97
| Facility | | $21.88 | $33.88 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $26.30 / $63.10
| Professional | | $12.02 | $26.30 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $28.18 / $36.31
| Facility | | $12.02 | $28.18 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $18.62 / $60.26
| Professional | | $7.41 | $18.62 | $60.26 |