- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $87.10 / $173.78
| Facility | | $32.36 | $87.10 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $19.50 / $100.00
| Professional | | $12.02 | $19.50 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $36.31 / $77.62
| Facility | | $8.91 | $36.31 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $18.62 / $69.18
| Professional | | $7.59 | $18.62 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $81.28 / $208.93
| Facility | | $34.67 | $81.28 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $17.78 / $44.67
| Professional | | $12.30 | $17.78 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $26.92 / $64.57
| Facility | | $10.47 | $26.92 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $15.49 / $25.70
| Professional | | $9.33 | $15.49 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.49 / $16.98 / $100.00
| Professional | | $15.49 | $16.98 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $15.49 / $35.48
| Professional | | $12.30 | $15.49 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $102.33 / $102.33
| Facility | | $102.33 | $102.33 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $18.62 / $18.62
| Professional | | $9.33 | $18.62 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $18.62 / $45.71
| Facility | | $12.88 | $18.62 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $14.45 / $35.48
| Professional | | $9.33 | $14.45 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $54.95 / $54.95
| Professional | | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $15.85 / $26.30
| Professional | | $12.30 | $15.85 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.92 / $9.33 / $15.49
| Facility | | $6.92 | $9.33 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $12.88 / $30.90
| Professional | | $9.33 | $12.88 | $30.90 |