- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.26 / $1,978.00 / $7,629.00
| Facility | | $23.26 | $1,978.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.94 / $21.95 / $38.88
| Professional | | $14.94 | $21.95 | $38.88 |
- 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
- $24.03 / $41.45 / $53.03
| Professional | | $24.03 | $41.45 | $53.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $24.30 / $42.73
| Professional | | $15.85 | $24.30 | $42.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.44 / $36.57 / $37.65
| Professional | | $28.44 | $36.57 | $37.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.68 / $45.68 / $45.68
| Facility | | $45.68 | $45.68 | $45.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,266.00 / $8,017.00
| Facility | | $540.00 | $2,266.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.94 / $23.33 / $137.25
| Professional | | $14.94 | $23.33 | $137.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.40 / $29.40 / $30.50
| Professional | | $29.40 | $29.40 | $30.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.59 / $28.59 / $28.59
| Facility | | $28.59 | $28.59 | $28.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.28 / $24.71 / $45.26
| Professional | | $16.28 | $24.71 | $45.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.91 / $16.20 / $24.29
| Facility | | $15.91 | $16.20 | $24.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.91 / $22.91 / $24.87
| Professional | | $15.91 | $22.91 | $24.87 |
- 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
- $22.67 / $28.78 / $51.65
| Professional | | $22.67 | $28.78 | $51.65 |