- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.66 / $230.00 / $363.00
| Facility | | $23.66 | $230.00 | $363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.00 / $20.97 / $420.00
| Professional | | $19.00 | $20.97 | $420.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.38 / $16.98 / $28.62
| Professional | | $13.38 | $16.98 | $28.62 |
- 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
- $19.00 / $27.78 / $57.00
| Professional | | $19.00 | $27.78 | $57.00 |
- 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 / $48.43
| Professional | | $45.00 | $45.00 | $48.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.26 / $30.94 / $39.78
| Facility | | $19.26 | $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
- $25.63 / $25.63 / $25.63
| Professional | | $25.63 | $25.63 | $25.63 |
- 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
- $23.00 / $25.00 / $40.44
| Professional | | $23.00 | $25.00 | $40.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.32 / $21.35 / $21.35
| Professional | | $19.32 | $21.35 | $21.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.68 / $41.54 / $92.40
| Professional | | $30.68 | $41.54 | $92.40 |
- 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 / $35.24 / $84.10
| Professional | | $7.25 | $35.24 | $84.10 |