- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.67 / $95.11 / $182.36
| Facility | | $41.67 | $95.11 | $182.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.84 / $32.06 / $298.00
| Professional | | $15.84 | $32.06 | $298.00 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Low / Median / High Price
- $12.92 / $12.92 / $17.64
| Professional | CQ | $12.92 | $12.92 | $17.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.07 / $148.72 / $287.66
| Facility | | $113.07 | $148.72 | $287.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.07 / $48.68 / $68.40
| Professional | | $30.07 | $48.68 | $68.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.57 / $43.00 / $104.00
| Facility | | $37.57 | $43.00 | $104.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.90 / $49.16 / $74.88
| Professional | | $27.90 | $49.16 | $74.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.82 / $62.73 / $149.85
| Facility | | $28.82 | $62.73 | $149.85 |
- Facility/Professional
- Facility
- Modifier
- CO
- Low / Median / High Price
- $61.71 / $127.37 / $127.37
| Facility | CO | $61.71 | $127.37 | $127.37 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Low / Median / High Price
- $61.71 / $127.37 / $127.37
| Facility | CQ | $61.71 | $127.37 | $127.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.27 / $32.84 / $95.72
| Professional | | $26.27 | $32.84 | $95.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.57 / $49.16 / $62.73
| Facility | | $37.57 | $49.16 | $62.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.15 / $54.12 / $77.95
| Professional | | $39.15 | $54.12 | $77.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.89 / $61.95 / $69.48
| Professional | | $31.89 | $61.95 | $69.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.27 / $32.84 / $79.83
| Professional | | $26.27 | $32.84 | $79.83 |