- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.66 / $230.00 / $773.36
| Facility | | $23.66 | $230.00 | $773.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.50 / $19.57 / $50.00
| Professional | | $18.50 | $19.57 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.88 / $24.88 / $24.88
| Professional | | $24.88 | $24.88 | $24.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.38 / $17.50 / $28.61
| Professional | | $13.38 | $17.50 | $28.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.77 / $38.77 / $38.77
| Facility | | $38.77 | $38.77 | $38.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.75 / $25.45 / $70.00
| Professional | | $19.75 | $25.45 | $70.00 |
- 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 / $51.05
| Professional | | $45.00 | $45.00 | $51.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.26 / $32.82 / $41.38
| Facility | | $19.26 | $32.82 | $41.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $32.82 / $63.40
| Professional | | $7.25 | $32.82 | $63.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.77 / $38.77 / $555.00
| Facility | | $38.77 | $38.77 | $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
- $17.51 / $19.35 / $19.35
| Professional | | $17.51 | $19.35 | $19.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.21 / $41.05 / $96.41
| Professional | | $29.21 | $41.05 | $96.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.82 / $41.38 / $41.38
| Facility | | $32.82 | $41.38 | $41.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $35.43 / $87.48
| Professional | | $7.25 | $35.43 | $87.48 |