- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.57 / $35.22 / $21,200.87
| Facility | | $30.57 | $35.22 | $21,200.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.98 / $30.58 / $36.97
| Professional | | $29.98 | $30.58 | $36.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Professional | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.98 / $40.47 / $107.69
| Facility | | $29.98 | $40.47 | $107.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.98 / $29.98 / $37.47
| Professional | | $29.98 | $29.98 | $37.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.28 / $28.28 / $29.98
| Facility | | $28.28 | $28.28 | $29.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.98 / $29.98 / $37.04
| Professional | | $29.98 | $29.98 | $37.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $35.22 / $58.83
| Facility | | $30.00 | $35.22 | $58.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.27 / $31.73 / $127.20
| Professional | | $27.27 | $31.73 | $127.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.38 / $29.98 / $35.68
| Professional | | $29.38 | $29.98 | $35.68 |