- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.23 / $84.00 / $196.20
| Facility | | $45.23 | $84.00 | $196.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.33 / $45.23 / $90.00
| Professional | | $35.33 | $45.23 | $90.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.10 / $56.53 / $167.82
| Facility | | $37.10 | $56.53 | $167.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $35.33 / $60.52
| Professional | | $14.13 | $35.33 | $60.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.76 / $51.66 / $89.12
| Facility | | $30.76 | $51.66 | $89.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.64 / $40.60 / $50.75
| Professional | | $19.64 | $40.60 | $50.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.15 / $34.08 / $37.48
| Professional | | $25.15 | $34.08 | $37.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.33 / $35.33 / $53.00
| Facility | | $35.33 | $35.33 | $53.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.80 / $35.33 / $70.66
| Facility | | $31.80 | $35.33 | $70.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.80 / $43.63 / $50.17
| Professional | | $31.80 | $43.63 | $50.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.10 / $57.98 / $97.16
| Facility | | $37.10 | $57.98 | $97.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.50 / $35.33 / $95.21
| Professional | | $26.50 | $35.33 | $95.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.13 / $18.95 / $45.11
| Professional | | $16.13 | $18.95 | $45.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.30 / $18.30 / $18.30
| Professional | | $18.30 | $18.30 | $18.30 |