- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.58 / $2,017.00 / $6,762.00
| Facility | | $37.58 | $2,017.00 | $6,762.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.10 / $28.54 / $40.51
| Professional | | $21.10 | $28.54 | $40.51 |
- 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
- $22.78 / $30.18 / $45.56
| Professional | | $22.78 | $30.18 | $45.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.49 / $23.49 / $46.98
| Professional | | $23.49 | $23.49 | $46.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.76 / $21.76 / $34.81
| Facility | | $21.76 | $21.76 | $34.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.27 / $35.24 / $54.18
| Professional | | $25.27 | $35.24 | $54.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $119.42
| Facility | | $55.00 | $55.00 | $119.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,210.02 / $2,582.05 / $2,685.33
| Professional | | $2,210.02 | $2,582.05 | $2,685.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.66 / $30.85 / $45.24
| Facility | | $23.66 | $30.85 | $45.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.93 / $42.88 / $58.96
| Professional | | $29.93 | $42.88 | $58.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.49 / $31.18 / $41.71
| Professional | | $23.49 | $31.18 | $41.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.66 / $30.82 / $45.24
| Facility | | $23.66 | $30.82 | $45.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.22 / $37.08 / $59.61
| Professional | | $26.22 | $37.08 | $59.61 |
- 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
- $26.73 / $35.36 / $53.92
| Professional | | $26.73 | $35.36 | $53.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.05 / $30.82 / $42.84
| Professional | | $27.05 | $30.82 | $42.84 |