- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.29 / $70.22 / $228.45
| Facility | | $31.29 | $70.22 | $228.45 |
- Facility/Professional
- Facility
- Modifier
- CO
- Low / Median / High Price
- $81.53 / $81.53 / $150.38
| Facility | CO | $81.53 | $81.53 | $150.38 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Low / Median / High Price
- $32.86 / $66.68 / $253.73
| Facility | CQ | $32.86 | $66.68 | $253.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.87 / $26.30 / $41.65
| Professional | | $20.87 | $26.30 | $41.65 |
- Facility/Professional
- Professional
- Modifier
- CO
- Low / Median / High Price
- $51.97 / $51.97 / $51.97
| Professional | CO | $51.97 | $51.97 | $51.97 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Low / Median / High Price
- $32.58 / $45.34 / $79.53
| Professional | CQ | $32.58 | $45.34 | $79.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.27 / $56.91 / $77.02
| Facility | | $39.27 | $56.91 | $77.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.68 / $38.47 / $45.26
| Professional | | $31.68 | $38.47 | $45.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $65.00 / $88.00
| Facility | | $55.00 | $65.00 | $88.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.89 / $60.80 / $114.99
| Professional | | $25.89 | $60.80 | $114.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.26 / $34.86 / $125.00
| Facility | | $23.26 | $34.86 | $125.00 |
- Facility/Professional
- Facility
- Modifier
- CO
- Low / Median / High Price
- $28.05 / $65.76 / $137.66
| Facility | CO | $28.05 | $65.76 | $137.66 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Low / Median / High Price
- $28.05 / $65.76 / $137.66
| Facility | CQ | $28.05 | $65.76 | $137.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.63 / $35.49 / $289.41
| Professional | | $25.63 | $35.49 | $289.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.63 / $34.36 / $51.53
| Professional | | $25.63 | $34.36 | $51.53 |