- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.77 / $38.19 / $182.36
| Facility | | $16.77 | $38.19 | $182.36 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Low / Median / High Price
- $37.57 / $74.40 / $191.00
| Facility | CQ | $37.57 | $74.40 | $191.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $13.98 / $49.00
| Professional | | $9.02 | $13.98 | $49.00 |
- Facility/Professional
- Professional
- Modifier
- CO
- Low / Median / High Price
- $12.89 / $12.89 / $12.89
| Professional | CO | $12.89 | $12.89 | $12.89 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Low / Median / High Price
- $11.49 / $19.07 / $19.07
| Professional | CQ | $11.49 | $19.07 | $19.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.07 / $148.72 / $287.66
| Facility | | $113.07 | $148.72 | $287.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.84 / $20.76 / $29.17
| Professional | | $12.84 | $20.76 | $29.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.00 / $16.27 / $59.00
| Facility | | $16.00 | $16.27 | $59.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.12 / $21.30 / $32.29
| Professional | | $12.12 | $21.30 | $32.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.58 / $27.99 / $112.80
| Facility | | $12.58 | $27.99 | $112.80 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Low / Median / High Price
- $26.96 / $55.33 / $55.33
| Facility | CQ | $26.96 | $55.33 | $55.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.18 / $13.91 / $35.22
| Professional | | $10.18 | $13.91 | $35.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.27 / $21.30 / $26.74
| Facility | | $16.27 | $21.30 | $26.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.29 / $21.51 / $33.22
| Professional | | $15.29 | $21.51 | $33.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.78 / $26.76 / $30.62
| Professional | | $13.78 | $26.76 | $30.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.13 / $13.91 / $33.82
| Professional | | $11.13 | $13.91 | $33.82 |