- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.17 / $32.17 / $59.84
| Facility | | $32.17 | $32.17 | $59.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.49 / $37.00 / $113.25
| Professional | | $26.49 | $37.00 | $113.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.17 / $72.62 / $147.69
| Facility | | $31.17 | $72.62 | $147.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.50 / $46.76 / $324.60
| Professional | | $29.50 | $46.76 | $324.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.34 / $79.65 / $103.74
| Facility | | $67.34 | $79.65 | $103.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.47 / $33.47 / $40.65
| Facility | | $33.47 | $33.47 | $40.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.86 / $55.79 / $101.12
| Professional | | $32.86 | $55.79 | $101.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.11 / $60.58 / $6,679.00
| Facility | | $34.11 | $60.58 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.05 / $31.67 / $51.89
| Professional | | $17.05 | $31.67 | $51.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.64 / $65.58 / $94.73
| Professional | | $35.64 | $65.58 | $94.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.75 / $52.75 / $220.15
| Professional | | $38.75 | $52.75 | $220.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.88 / $147.69 / $147.69
| Facility | | $67.88 | $147.69 | $147.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.58 / $53.10 / $324.60
| Professional | | $34.58 | $53.10 | $324.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.11 / $32.45 / $46.76
| Professional | | $24.11 | $32.45 | $46.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.75 / $45.14 / $116.52
| Professional | | $33.75 | $45.14 | $116.52 |