- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.22 / $2,899.00 / $9,897.00
| Facility | | $16.22 | $2,899.00 | $9,897.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.78 / $16.36 / $28.16
| Professional | | $13.78 | $16.36 | $28.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.43 / $60.00 / $18,738.00
| Facility | | $5.43 | $60.00 | $18,738.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.98 / $19.03 / $27.36
| Professional | | $14.98 | $19.03 | $27.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.92 / $27.71 / $29.44
| Professional | | $19.92 | $27.71 | $29.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.86 / $12.86 / $18.86
| Facility | | $12.86 | $12.86 | $18.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.23 / $21.03 / $32.97
| Professional | | $16.23 | $21.03 | $32.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.95 / $9,102.00 / $11,500.00
| Facility | | $78.95 | $9,102.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.00 / $198.00 / $198.00
| Professional | | $198.00 | $198.00 | $198.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.17 / $19.35 / $28.44
| Facility | | $15.17 | $19.35 | $28.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.79 / $25.62 / $33.09
| Professional | | $17.79 | $25.62 | $33.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.43 / $17.82 / $22.49
| Professional | | $13.43 | $17.82 | $22.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.18 / $19.38 / $30.48
| Facility | | $15.18 | $19.38 | $30.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.87 / $22.15 / $34.63
| Professional | | $16.87 | $22.15 | $34.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.00 / $952.00 / $2,405.00
| Facility | | $161.00 | $952.00 | $2,405.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.60 / $19.13 / $29.00
| Professional | | $14.60 | $19.13 | $29.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.18 / $17.32 / $24.07
| Professional | | $15.18 | $17.32 | $24.07 |