- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.04 / $55.04 / $55.04
| Facility | | $55.04 | $55.04 | $55.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.97 / $42.87 / $55.04
| Professional | | $23.97 | $42.87 | $55.04 |
- 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 / $55.42 / $97.19
| Professional | | $34.61 | $55.42 | $97.19 |
- 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 / $76.20
| Professional | | $15.53 | $17.07 | $76.20 |
- 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 / $124.40 / $128.44
| Facility | | $85.00 | $124.40 | $128.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.34 / $248.34 / $248.34
| Professional | | $248.34 | $248.34 | $248.34 |
- 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
- $24.04 / $33.15 / $64.67
| Facility | | $24.04 | $33.15 | $64.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.23 / $62.97 / $76.20
| Professional | | $20.23 | $62.97 | $76.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.90 / $37.90 / $37.90
| Facility | | $37.90 | $37.90 | $37.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.24 / $52.99 / $126.89
| Professional | | $37.24 | $52.99 | $126.89 |