- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $102.33 / $151.36
| Facility | | $36.31 | $102.33 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $44.67 / $97.72
| Professional | | $28.84 | $44.67 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $38.02 / $75.86
| Professional | | $38.02 | $38.02 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,412.54 / $2,630.27
| Facility | | $1,288.25 | $1,412.54 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $52.48 / $74.13
| Professional | | $25.70 | $52.48 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $63.10 / $117.49
| Professional | | $38.02 | $63.10 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $7,413.10 / $7,413.10
| Facility | | $7,413.10 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $57.54 / $107.15
| Professional | | $31.62 | $57.54 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $7,413.10 / $7,413.10
| Facility | | $7,413.10 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $54.95 / $102.33
| Professional | | $32.36 | $54.95 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.62 / $31.62 / $51.29
| Facility | | $31.62 | $31.62 | $51.29 |