- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.41 / $68.23 / $102.00
| Facility | | $43.41 | $68.23 | $102.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.29 / $43.41 / $102.00
| Professional | | $41.29 | $43.41 | $102.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.11 / $46.05 / $62.51
| Facility | | $34.11 | $46.05 | $62.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.47 / $35.72 / $75.00
| Professional | | $32.47 | $35.72 | $75.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.00 / $54.50 / $100.00
| Facility | | $51.00 | $54.50 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.10 / $47.10 / $116.81
| Professional | | $47.10 | $47.10 | $116.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.95 / $40.95 / $43.41
| Facility | | $40.95 | $40.95 | $43.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.41 / $43.41 / $43.41
| Professional | | $43.41 | $43.41 | $43.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.07 / $52.09 / $99.84
| Professional | | $39.07 | $52.09 | $99.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $221.08 / $221.08
| Facility | | $75.00 | $221.08 | $221.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.95 / $43.41 / $61.54
| Facility | | $40.95 | $43.41 | $61.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.41 / $43.41 / $93.90
| Professional | | $43.41 | $43.41 | $93.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.28 / $69.28 / $69.28
| Professional | | $69.28 | $69.28 | $69.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.72 / $47.75 / $73.80
| Professional | | $34.72 | $47.75 | $73.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.41 / $43.41 / $89.22
| Professional | | $43.41 | $43.41 | $89.22 |