- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.77 / $995.04 / $5,743.00
| Facility | | $40.77 | $995.04 | $5,743.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.41 / $36.28 / $75.40
| Professional | | $21.41 | $36.28 | $75.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.80 / $36.86 / $55.99
| Professional | | $23.80 | $36.86 | $55.99 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $35.70 / $55.31 / $83.99
| Professional | 50 | $35.70 | $55.31 | $83.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.95 / $27.95 / $916.00
| Professional | | $27.95 | $27.95 | $916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.43 / $42.43 / $42.43
| Facility | | $42.43 | $42.43 | $42.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.45 / $38.61 / $73.42
| Professional | | $23.45 | $38.61 | $73.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.42 / $45.83 / $54.56
| Professional | | $41.42 | $45.83 | $54.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.84 / $37.65 / $54.55
| Facility | | $24.84 | $37.65 | $54.55 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $35.72 / $56.04 / $61.80
| Facility | 50 | $35.72 | $56.04 | $61.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $55.00 / $83.00
| Professional | | $50.00 | $55.00 | $83.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.03 / $32.56 / $1,098.00
| Facility | | $21.03 | $32.56 | $1,098.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.27 / $49.75 / $1,098.00
| Professional | | $34.27 | $49.75 | $1,098.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.00 / $1,148.00 / $2,364.00
| Facility | | $296.00 | $1,148.00 | $2,364.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.10 / $42.95 / $74.34
| Professional | | $28.10 | $42.95 | $74.34 |