- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.32 / $1,473.20 / $3,363.00
| Facility | | $85.32 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.66 / $27.34 / $65.98
| Professional | | $12.66 | $27.34 | $65.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.28 / $140.86 / $2,713.00
| Facility | | $34.28 | $140.86 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.52 / $40.11 / $124.50
| Professional | | $15.52 | $40.11 | $124.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.18 / $21.03 / $41.26
| Facility | | $16.18 | $21.03 | $41.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.61 / $39.96 / $82.98
| Professional | | $20.61 | $39.96 | $82.98 |
- 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
- $15.95 / $37.71 / $86.64
| Professional | | $15.95 | $37.71 | $86.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.85 / $168.26 / $6,679.00
| Facility | | $16.85 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.75 / $46.45 / $64.12
| Professional | | $36.75 | $46.45 | $64.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.61 / $40.54 / $97.44
| Professional | | $17.61 | $40.54 | $97.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.51 / $100.02 / $110.53
| Facility | | $72.51 | $100.02 | $110.53 |
- 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
- $32.51 / $62.23 / $239.28
| Professional | | $32.51 | $62.23 | $239.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.65 / $26.65 / $28.07
| Professional | | $26.65 | $26.65 | $28.07 |
- 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
- $25.11 / $46.91 / $96.66
| Professional | | $25.11 | $46.91 | $96.66 |