- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.84 / $80.19 / $4,264.00
| Facility | | $13.84 | $80.19 | $4,264.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.82 / $12.43 / $27.75
| Professional | | $6.82 | $12.43 | $27.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.43 / $14.62 / $35.69
| Professional | | $12.43 | $14.62 | $35.69 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $14.09 / $22.38 / $35.69
| Professional | 50 | $14.09 | $22.38 | $35.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.20 / $13.77 / $26.76
| Professional | | $7.20 | $13.77 | $26.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.61 / $21.36 / $21.91
| Professional | | $16.61 | $21.36 | $21.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.60 / $151.00 / $300.89
| Facility | | $135.60 | $151.00 | $300.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.70 / $690.00 / $8,017.00
| Facility | | $57.70 | $690.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.89 / $13.16 / $27.78
| Professional | | $6.89 | $13.16 | $27.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.00 / $25.00 / $26.80
| Professional | | $25.00 | $25.00 | $26.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.75 / $12.75 / $12.75
| Facility | | $12.75 | $12.75 | $12.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.35 / $13.89 / $27.08
| Professional | | $7.35 | $13.89 | $27.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.33 / $8.98 / $15.65
| Facility | | $7.33 | $8.98 | $15.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.33 / $13.42 / $14.52
| Professional | | $7.33 | $13.42 | $14.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $674.00 / $4,300.00
| Facility | | $144.00 | $674.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.53 / $17.02 / $27.38
| Professional | | $12.53 | $17.02 | $27.38 |