- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.33 / $30.33 / $30.33
| Facility | | $30.33 | $30.33 | $30.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.33 / $37.47 / $49.01
| Professional | | $30.33 | $37.47 | $49.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.00 / $486.00 / $876.00
| Facility | | $203.00 | $486.00 | $876.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.61 / $70.58 / $118.26
| Professional | | $34.61 | $70.58 | $118.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.15 / $14.05 / $100.00
| Facility | | $9.15 | $14.05 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.60 / $8.00 / $20.00
| Professional | | $5.60 | $8.00 | $20.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.53 / $17.07 / $100.99
| Professional | | $15.53 | $17.07 | $100.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.00 / $638.07 / $801.00
| Professional | | $350.00 | $638.07 | $801.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $184.31 / $204.49
| Facility | | $85.00 | $184.31 | $204.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.19 / $280.19 / $329.25
| Professional | | $280.19 | $280.19 | $329.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.00 / $60.00 / $85.00
| Professional | | $60.00 | $60.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.33 / $45.19 / $60.91
| Facility | | $30.33 | $45.19 | $60.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.09 / $62.97 / $100.99
| Professional | | $38.09 | $62.97 | $100.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.15 / $50.15 / $50.15
| Facility | | $50.15 | $50.15 | $50.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.97 / $53.76 / $133.80
| Professional | | $38.97 | $53.76 | $133.80 |