- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.73 / $32.35 / $101.40
| Facility | | $30.73 | $32.35 | $101.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $32.35 / $53.25
| Professional | | $30.00 | $32.35 | $53.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.45 / $31.19 / $31.19
| Professional | | $29.45 | $31.19 | $31.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.05 / $28.05 / $30.86
| Facility | | $28.05 | $28.05 | $30.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.05 / $28.05 / $28.05
| Professional | | $28.05 | $28.05 | $28.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.44 / $32.38 / $132.21
| Facility | | $31.44 | $32.38 | $132.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.25 / $35.25 / $35.25
| Professional | | $35.25 | $35.25 | $35.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.86 / $33.86 / $69.41
| Facility | | $33.86 | $33.86 | $69.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.86 / $33.86 / $33.86
| Professional | | $33.86 | $33.86 | $33.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.04 / $33.04 / $33.04
| Facility | | $33.04 | $33.04 | $33.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.04 / $33.04 / $35.74
| Professional | | $33.04 | $33.04 | $35.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.54 / $36.54 / $36.54
| Facility | | $36.54 | $36.54 | $36.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.38 / $32.38 / $597.00
| Facility | | $32.38 | $32.38 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $35.25
| Professional | | $30.00 | $30.00 | $35.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.47 / $37.61 / $48.29
| Professional | | $31.47 | $37.61 | $48.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.91 / $33.04 / $33.04
| Facility | | $23.91 | $33.04 | $33.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.91 / $23.91 / $35.74
| Professional | | $23.91 | $23.91 | $35.74 |