- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.94 / $28.94 / $48.61
| Facility | | $28.94 | $28.94 | $48.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.94 / $48.61 / $84.64
| Professional | | $28.94 | $48.61 | $84.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $150.72 / $2,713.00
| Facility | | $55.00 | $150.72 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.71 / $84.13 / $1,641.00
| Professional | | $39.71 | $84.13 | $1,641.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.33 / $45.40 / $86.68
| Facility | | $35.33 | $45.40 | $86.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.56 / $75.22 / $138.65
| Professional | | $39.56 | $75.22 | $138.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.52 / $168.26 / $6,679.00
| Facility | | $36.52 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.45 / $78.09 / $107.80
| Professional | | $64.45 | $78.09 | $107.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.04 / $83.71 / $152.41
| Professional | | $39.04 | $83.71 | $152.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.19 / $117.82 / $1,687.42
| Professional | | $61.19 | $117.82 | $1,687.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.17 / $86.56 / $170.74
| Professional | | $58.17 | $86.56 | $170.74 |