- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.55 / $230.00 / $363.00
| Facility | | $17.55 | $230.00 | $363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.72 / $15.00 / $450.00
| Professional | | $13.72 | $15.00 | $450.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $12.75 / $16.50
| Professional | | $10.30 | $12.75 | $16.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.28 / $37.28 / $37.28
| Facility | | $37.28 | $37.28 | $37.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $19.17 / $50.00
| Professional | | $10.00 | $19.17 | $50.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.00 / $45.00 / $45.00
| Facility | | $45.00 | $45.00 | $45.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.00 / $45.00 / $50.61
| Professional | | $45.00 | $45.00 | $50.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.85 / $30.94 / $39.78
| Facility | | $16.85 | $30.94 | $39.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $30.94 / $60.95
| Professional | | $7.25 | $30.94 | $60.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.82 / $12.82 / $12.82
| Professional | | $12.82 | $12.82 | $12.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.28 / $37.28 / $555.00
| Facility | | $37.28 | $37.28 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.00 / $20.00 / $40.44
| Professional | | $14.00 | $20.00 | $40.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.68 / $18.43 / $18.43
| Professional | | $16.68 | $18.43 | $18.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.14 / $227.19 / $268.12
| Facility | | $198.14 | $227.19 | $268.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.81 / $41.69 / $110.41
| Professional | | $30.81 | $41.69 | $110.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.94 / $39.78 / $39.78
| Facility | | $30.94 | $39.78 | $39.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $34.06 / $84.10
| Professional | | $7.25 | $34.06 | $84.10 |