- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.96 / $135.08 / $227.69
| Facility | | $13.96 | $135.08 | $227.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.03 / $13.03 / $126.93
| Professional | | $13.03 | $13.03 | $126.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.09 / $36.65 / $71.47
| Facility | | $28.09 | $36.65 | $71.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $30.00 / $32.36
| Professional | | $15.00 | $30.00 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.72 / $28.39 / $44.88
| Professional | | $22.72 | $28.39 | $44.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.84 / $39.56 / $142.87
| Facility | | $11.84 | $39.56 | $142.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.84 / $11.84 / $50.00
| Professional | | $11.84 | $11.84 | $50.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.18 / $40.21 / $61.88
| Facility | | $24.18 | $40.21 | $61.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.71 / $43.86 / $56.87
| Professional | | $23.71 | $43.86 | $56.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.25 / $11.84 / $39.47
| Professional | | $11.25 | $11.84 | $39.47 |