- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.21 / $2,747.00 / $4,806.64
| Facility | | $12.21 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.21 / $16.89 / $31.83
| Professional | | $12.21 | $16.89 | $31.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.76 / $941.10 / $4,142.00
| Facility | | $39.76 | $941.10 | $4,142.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.79 / $27.53 / $63.90
| Professional | | $13.79 | $27.53 | $63.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.47 / $24.01 / $42.37
| Facility | | $18.47 | $24.01 | $42.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.05 / $32.03 / $46.65
| Professional | | $21.05 | $32.03 | $46.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.93 / $27.05 / $60.88
| Professional | | $17.93 | $27.05 | $60.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.80 / $67.48 / $6,679.00
| Facility | | $18.80 | $67.48 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.12 / $24.93 / $34.40
| Professional | | $20.12 | $24.93 | $34.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.66 / $39.46 / $52.26
| Professional | | $19.66 | $39.46 | $52.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.58 / $165.58 / $165.58
| Facility | | $165.58 | $165.58 | $165.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.98 / $34.35 / $93.14
| Professional | | $18.98 | $34.35 | $93.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.95 / $1,818.00 / $11,500.00
| Facility | | $78.95 | $1,818.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.80 / $31.87 / $198.00
| Professional | | $19.80 | $31.87 | $198.00 |
- 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
- $16.80 / $25.27 / $48.45
| Professional | | $16.80 | $25.27 | $48.45 |