- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $30.20 / $177.83
| Facility | | $16.98 | $30.20 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $12.88 / $57.54
| Professional | | $8.91 | $12.88 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Low / Median / High Price
- $6.31 / $24.55 / $25.70
| Professional | CQ | $6.31 | $24.55 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $12.30 / $18.62
| Professional | | $12.30 | $12.30 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Low / Median / High Price
- $9.77 / $9.77 / $22.91
| Professional | CQ | $9.77 | $9.77 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $141.25 / $288.40
| Facility | | $112.20 | $141.25 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $20.89 / $28.84
| Professional | | $12.30 | $20.89 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.95 / $19.95 / $75.86
| Facility | | $19.95 | $19.95 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $19.50 / $33.11
| Professional | | $12.02 | $19.50 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $24.55 / $97.72
| Facility | | $12.02 | $24.55 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $18.20 / $91.20
| Professional | | $11.75 | $18.20 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $25.12 / $30.20
| Professional | | $18.20 | $25.12 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $21.38 / $33.11
| Professional | | $18.20 | $21.38 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $134.90 / $245.47
| Facility | | $114.82 | $134.90 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.48 / $12.88 / $12.88
| Facility | | $11.48 | $12.88 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $14.13 / $33.88
| Professional | | $11.75 | $14.13 | $33.88 |