- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.36 / $45.28 / $84.15
| Facility | | $35.36 | $45.28 | $84.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.23 / $45.24 / $90.00
| Professional | | $45.23 | $45.24 | $90.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.94 / $53.67 / $167.82
| Facility | | $10.94 | $53.67 | $167.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.20 / $35.34 / $86.06
| Professional | | $21.20 | $35.34 | $86.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.98 / $18.13 / $35.58
| Facility | | $11.98 | $18.13 | $35.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.98 / $11.98 / $34.97
| Professional | | $11.98 | $11.98 | $34.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.19 / $24.35 / $27.55
| Facility | | $23.19 | $24.35 | $27.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.72 / $40.60 / $50.75
| Professional | | $18.72 | $40.60 | $50.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.04 / $111.29 / $8,090.00
| Facility | | $36.04 | $111.29 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.04 / $46.55 / $59.86
| Professional | | $36.04 | $46.55 | $59.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.33 / $46.64 / $101.07
| Professional | | $35.33 | $46.64 | $101.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.03 / $44.32 / $121.98
| Facility | | $43.03 | $44.32 | $121.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.47 / $167.82 / $167.82
| Facility | | $61.47 | $167.82 | $167.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.90 / $32.24 / $71.91
| Professional | | $15.90 | $32.24 | $71.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.96 / $32.24 / $70.08
| Professional | | $16.96 | $32.24 | $70.08 |