- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.15 / $2,000.00 / $6,762.00
| Facility | | $29.15 | $2,000.00 | $6,762.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.33 / $26.41 / $51.85
| Professional | | $13.33 | $26.41 | $51.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.31 / $65.00 / $3,989.00
| Facility | | $14.31 | $65.00 | $3,989.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.70 / $27.68 / $45.13
| Professional | | $15.70 | $27.68 | $45.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.92 / $14.92 / $32.90
| Facility | | $14.92 | $14.92 | $32.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.68 / $34.04 / $58.72
| Professional | | $17.68 | $34.04 | $58.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $80.51
| Facility | | $55.00 | $55.00 | $80.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.00 / $238.08 / $271.50
| Professional | | $163.00 | $238.08 | $271.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.19 / $31.78 / $54.98
| Facility | | $16.19 | $31.78 | $54.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.21 / $32.34 / $57.06
| Professional | | $20.21 | $32.34 | $57.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.48 / $33.68 / $45.21
| Professional | | $16.48 | $33.68 | $45.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.19 / $31.77 / $56.38
| Facility | | $16.19 | $31.77 | $56.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.35 / $36.21 / $62.12
| Professional | | $18.35 | $36.21 | $62.12 |
- 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
- $26.81 / $35.74 / $57.08
| Professional | | $26.81 | $35.74 | $57.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.05 / $30.62 / $42.87
| Professional | | $27.05 | $30.62 | $42.87 |