- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $79.43 / $117.49
| Facility | | $72.44 | $79.43 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $91.20 / $117.49
| Professional | | $67.61 | $91.20 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.48 / $21.38 / $45.71
| Facility | | $11.48 | $21.38 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.51 / $8.51 / $9.77
| Professional | | $8.51 | $8.51 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $134.90
| Facility | | $10.47 | $10.47 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $114.82 / $114.82
| Facility | | $79.43 | $114.82 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $100.00 / $114.82
| Professional | | $11.48 | $100.00 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $660.69 / $660.69
| Facility | | $194.98 | $660.69 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.49 / $70.79 / $147.91
| Facility | | $13.49 | $70.79 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $107.15 / $117.49
| Professional | | $67.61 | $107.15 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $134.90 / $134.90
| Professional | | $9.12 | $134.90 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $70.79 / $154.88
| Facility | | $12.88 | $70.79 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $102.33 / $112.20
| Professional | | $16.60 | $102.33 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.76 / $46.77 / $79.43
| Facility | | $6.76 | $46.77 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $72.44 / $138.04
| Professional | | $41.69 | $72.44 | $138.04 |