- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.39 / $9,674.00 / $19,860.00
| Facility | | $81.39 | $9,674.00 | $19,860.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.67 / $74.78 / $93.17
| Professional | | $45.67 | $74.78 | $93.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,456.00 / $5,944.00 / $12,615.00
| Facility | | $2,456.00 | $5,944.00 | $12,615.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.93 / $85.69 / $158.74
| Professional | | $59.93 | $85.69 | $158.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.09 / $79.00 / $91.00
| Facility | | $77.09 | $79.00 | $91.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.69 / $12.41 / $30.68
| Professional | | $8.69 | $12.41 | $30.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.23 / $17.98 / $22.58
| Professional | | $17.23 | $17.98 | $22.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.76 / $14.33 / $26.91
| Professional | | $10.76 | $14.33 | $26.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.33 / $286.08 / $327.27
| Facility | | $47.33 | $286.08 | $327.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.39 / $322.39 / $322.39
| Professional | | $322.39 | $322.39 | $322.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.70 / $15.90 / $92.29
| Facility | | $13.70 | $15.90 | $92.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.85 / $14.89 / $20.25
| Professional | | $11.85 | $14.89 | $20.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.57 / $12.19 / $14.53
| Professional | | $10.57 | $12.19 | $14.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $587.00 / $1,572.00 / $5,830.00
| Facility | | $587.00 | $1,572.00 | $5,830.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.74 / $12.99 / $30.23
| Professional | | $9.74 | $12.99 | $30.23 |