- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.61 / $2,020.00 / $6,762.00
| Facility | | $36.61 | $2,020.00 | $6,762.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.77 / $19.77 / $30.90
| Professional | | $13.77 | $19.77 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.47 / $467.43 / $3,989.00
| Facility | | $83.47 | $467.43 | $3,989.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.08 / $22.28 / $37.06
| Professional | | $15.08 | $22.28 | $37.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.49 / $70.88 / $70.88
| Facility | | $14.49 | $70.88 | $70.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.46 / $26.11 / $41.96
| Professional | | $17.46 | $26.11 | $41.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $80.94
| Facility | | $55.00 | $55.00 | $80.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,376.87 / $3,779.26 / $3,930.43
| Professional | | $3,376.87 | $3,779.26 | $3,930.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.95 / $23.09 / $34.34
| Facility | | $15.95 | $23.09 | $34.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.21 / $30.08 / $43.91
| Professional | | $20.21 | $30.08 | $43.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.83 / $22.89 / $31.77
| Professional | | $15.83 | $22.89 | $31.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.95 / $23.09 / $34.94
| Facility | | $15.95 | $23.09 | $34.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.95 / $27.23 / $45.40
| Professional | | $17.95 | $27.23 | $45.40 |
- 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
- $20.54 / $27.39 / $43.57
| Professional | | $20.54 | $27.39 | $43.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.14 / $22.89 / $31.93
| Professional | | $20.14 | $22.89 | $31.93 |