- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.63 / $80.86 / $120.00
| Facility | | $20.63 | $80.86 | $120.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.76 / $20.48 / $29.00
| Professional | | $12.76 | $20.48 | $29.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.04 / $14.45 / $16.72
| Professional | | $12.04 | $14.45 | $16.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.62 / $37.89 / $69.39
| Facility | | $10.62 | $37.89 | $69.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.00 / $16.00 / $22.80
| Professional | | $11.00 | $16.00 | $22.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.64 / $39.13 / $70.43
| Facility | | $16.64 | $39.13 | $70.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.14 / $29.32 / $36.65
| Professional | | $16.14 | $29.32 | $36.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.26 / $20.04 / $114.38
| Facility | | $19.26 | $20.04 | $114.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.11 / $14.33 / $21.83
| Professional | | $10.11 | $14.33 | $21.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.11 / $14.33 / $19.26
| Professional | | $10.11 | $14.33 | $19.26 |