- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.00 / $25.00 / $30.73
| Facility | | $25.00 | $25.00 | $30.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.76 / $19.57 / $28.97
| Professional | | $18.76 | $19.57 | $28.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.73 / $80.00 / $172.90
| Facility | | $30.73 | $80.00 | $172.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.43 / $56.80 / $174.02
| Professional | | $27.43 | $56.80 | $174.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.70 / $59.81 / $71.11
| Facility | | $45.70 | $59.81 | $71.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.36 / $46.32 / $92.91
| Professional | | $36.36 | $46.32 | $92.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.34 / $27.78 / $40.44
| Professional | | $19.34 | $27.78 | $40.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.73 / $30.73 / $30.73
| Facility | | $30.73 | $30.73 | $30.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.73 / $30.73 / $53.63
| Professional | | $30.73 | $30.73 | $53.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.04 / $60.33 / $87.23
| Professional | | $30.04 | $60.33 | $87.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.00 / $186.00 / $372.00
| Professional | | $62.00 | $186.00 | $372.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $172.90
| Facility | | $80.00 | $80.00 | $172.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.26 / $69.62 / $174.02
| Professional | | $32.26 | $69.62 | $174.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $30.73 / $35.34
| Professional | | $30.00 | $30.73 | $35.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.36 / $49.00 / $127.12
| Professional | | $28.36 | $49.00 | $127.12 |