- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.23 / $552.66 / $5,627.00
| Facility | | $57.23 | $552.66 | $5,627.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.85 / $48.16 / $213.00
| Professional | | $27.85 | $48.16 | $213.00 |
- 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
- $55.92 / $63.58 / $66.55
| Professional | | $55.92 | $63.58 | $66.55 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $55.92 / $63.58 / $91.41
| Professional | 50 | $55.92 | $63.58 | $91.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.83 / $49.95 / $86.80
| Professional | | $30.83 | $49.95 | $86.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.75 / $87.10 / $89.68
| Professional | | $67.75 | $87.10 | $89.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.69 / $290.43 / $391.31
| Facility | | $183.69 | $290.43 | $391.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.05 / $1,340.00 / $5,958.00
| Facility | | $58.05 | $1,340.00 | $5,958.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $53.89 / $233.00
| Professional | | $29.51 | $53.89 | $233.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.40 / $44.40 / $89.83
| Professional | | $44.40 | $44.40 | $89.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.45 / $54.45 / $54.45
| Facility | | $54.45 | $54.45 | $54.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.71 / $50.57 / $90.03
| Professional | | $31.71 | $50.57 | $90.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.66 / $30.84 / $65.26
| Facility | | $29.66 | $30.84 | $65.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.21 / $54.13 / $59.30
| Professional | | $30.21 | $54.13 | $59.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.03 / $436.00 / $3,742.00
| Facility | | $172.03 | $436.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.86 / $57.50 / $96.53
| Professional | | $40.86 | $57.50 | $96.53 |