- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.15 / $32.84 / $408.71
| Facility | | $24.15 | $32.84 | $408.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.21 / $32.01 / $86.36
| Professional | | $22.21 | $32.01 | $86.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.41 / $58.61 / $162.35
| Facility | | $25.41 | $58.61 | $162.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.96 / $38.90 / $384.71
| Professional | | $23.96 | $38.90 | $384.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.43 / $65.75 / $87.95
| Facility | | $55.43 | $65.75 | $87.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.54 / $44.82 / $60.16
| Professional | | $34.54 | $44.82 | $60.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.22 / $38.22 / $38.22
| Facility | | $38.22 | $38.22 | $38.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.17 / $43.91 / $84.40
| Professional | | $26.17 | $43.91 | $84.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.93 / $49.38 / $8,090.00
| Facility | | $23.93 | $49.38 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.96 / $25.92 / $42.47
| Professional | | $13.96 | $25.92 | $42.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.19 / $52.50 / $76.05
| Professional | | $27.19 | $52.50 | $76.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.45 / $41.38 / $75.47
| Professional | | $28.45 | $41.38 | $75.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.49 / $162.35 / $162.35
| Facility | | $56.49 | $162.35 | $162.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.96 / $43.58 / $384.71
| Professional | | $27.96 | $43.58 | $384.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.67 / $34.97 / $76.31
| Professional | | $27.67 | $34.97 | $76.31 |