- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.44 / $108.00 / $108.00
| Facility | | $19.44 | $108.00 | $108.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.61 / $19.44 / $24.37
| Professional | | $15.61 | $19.44 | $24.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.84 / $3.84 / $3.84
| Professional | | $3.84 | $3.84 | $3.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.58 / $5.39 / $5.39
| Professional | | $4.58 | $5.39 | $5.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.81 / $6.81 / $80.00
| Facility | | $6.81 | $6.81 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.08 / $12.00 / $15.00
| Professional | | $5.08 | $12.00 | $15.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.00 / $70.00 / $80.00
| Facility | | $70.00 | $70.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.00 / $41.00 / $45.23
| Professional | | $41.00 | $41.00 | $45.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.66 / $19.00 / $23.50
| Facility | | $4.66 | $19.00 | $23.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.50 / $12.50 / $15.00
| Professional | | $12.50 | $12.50 | $15.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $10.02 / $10.70
| Professional | | $5.50 | $10.02 | $10.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.78 / $19.44 / $24.25
| Facility | | $4.78 | $19.44 | $24.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.21 / $12.00 / $15.00
| Professional | | $5.21 | $12.00 | $15.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.33 / $5.99 / $10.00
| Professional | | $4.33 | $5.99 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.08 / $6.34 / $7.11
| Professional | | $5.08 | $6.34 | $7.11 |