- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.69 / $1,411.87 / $3,363.00
| Facility | | $82.69 | $1,411.87 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.31 / $71.45 / $323.39
| Professional | | $23.31 | $71.45 | $323.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $818.35 / $2,796.00
| Facility | | $55.00 | $818.35 | $2,796.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.54 / $68.00 / $177.18
| Professional | | $23.54 | $68.00 | $177.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.12 / $33.36 / $63.98
| Facility | | $26.12 | $33.36 | $63.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.04 / $60.33 / $125.29
| Professional | | $34.04 | $60.33 | $125.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.71 / $59.07 / $129.88
| Professional | | $24.71 | $59.07 | $129.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $168.26 / $6,679.00
| Facility | | $25.70 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.15 / $69.87 / $96.82
| Professional | | $55.15 | $69.87 | $96.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.62 / $60.62 / $134.27
| Professional | | $26.62 | $60.62 | $134.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.08 / $155.60 / $303.18
| Facility | | $126.08 | $155.60 | $303.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.81 / $125.00 / $328.75
| Professional | | $60.81 | $125.00 | $328.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.46 / $88.70 / $356.24
| Professional | | $59.46 | $88.70 | $356.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.86 / $51.82 / $100.69
| Professional | | $23.86 | $51.82 | $100.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.22 / $77.86 / $138.72
| Professional | | $57.22 | $77.86 | $138.72 |