- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.46 / $264.39 / $1,894.00
| Facility | | $35.46 | $264.39 | $1,894.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $809.21 / $945.62 / $1,450.61
| Facility | | $809.21 | $945.62 | $1,450.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.88 / $133.41 / $766.26
| Facility | | $41.88 | $133.41 | $766.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.79 / $316.22 / $1,590.00
| Facility | | $45.79 | $316.22 | $1,590.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.88 / $133.41 / $766.26
| Facility | | $41.88 | $133.41 | $766.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.29 / $307.18 / $960.07
| Professional | | $94.29 | $307.18 | $960.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.52 / $107.61 / $190.76
| Facility | | $80.52 | $107.61 | $190.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,008.00 / $1,423.00 / $2,202.90
| Facility | | $1,008.00 | $1,423.00 | $2,202.90 |