- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $38.90 / $64.57
| Facility | | $32.36 | $38.90 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $39.81 / $141.25
| Professional | | $26.92 | $39.81 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $72.44 / $186.21
| Facility | | $30.90 | $72.44 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $45.71 / $323.59
| Professional | | $28.18 | $45.71 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $81.28 / $107.15
| Facility | | $69.18 | $81.28 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.74 / $40.74 / $40.74
| Facility | | $40.74 | $40.74 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $52.48 / $100.00
| Professional | | $33.11 | $52.48 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $63.10 / $7,079.46
| Facility | | $30.20 | $63.10 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $30.90 / $57.54
| Professional | | $17.38 | $30.90 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $54.95 / $85.11
| Professional | | $30.20 | $54.95 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $218.78 / $234.42
| Professional | | $52.48 | $218.78 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $72.44 / $186.21
| Facility | | $30.90 | $72.44 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $46.77 / $323.59
| Professional | | $28.84 | $46.77 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $33.88 / $91.20
| Professional | | $25.12 | $33.88 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $50.12 / $91.20
| Professional | | $32.36 | $50.12 | $91.20 |