- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.28 / $988.00 / $5,958.00
| Facility | | $24.28 | $988.00 | $5,958.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.43 / $23.29 / $71.89
| Professional | | $18.43 | $23.29 | $71.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.78 / $29.78 / $29.78
| Professional | | $29.78 | $29.78 | $29.78 |
- 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
- $25.84 / $32.13 / $63.02
| Professional | | $25.84 | $32.13 | $63.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.73 / $31.53 / $53.39
| Professional | | $21.73 | $31.53 | $53.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.11 / $39.75 / $40.47
| Professional | | $30.11 | $39.75 | $40.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.83 / $1,037.50 / $1,076.33
| Facility | | $90.83 | $1,037.50 | $1,076.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.47 / $25.47 / $25.47
| Professional | | $25.47 | $25.47 | $25.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.50 / $1,544.00 / $7,175.00
| Facility | | $30.50 | $1,544.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.64 / $26.38 / $114.00
| Professional | | $18.64 | $26.38 | $114.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.70 / $49.80 / $67.90
| Professional | | $46.70 | $49.80 | $67.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.14 / $31.61 / $54.19
| Professional | | $23.14 | $31.61 | $54.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.20 / $25.58 / $48.93
| Facility | | $20.20 | $25.58 | $48.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.20 / $24.94 / $41.85
| Professional | | $20.20 | $24.94 | $41.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $577.00 / $3,742.00
| Facility | | $162.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.26 / $32.84 / $54.04
| Professional | | $23.26 | $32.84 | $54.04 |