- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.64 / $67.38 / $127.14
| Facility | | $38.64 | $67.38 | $127.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.64 / $67.38 / $149.87
| Professional | | $38.64 | $67.38 | $149.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.10 / $627.00 / $7,231.00
| Facility | | $122.10 | $627.00 | $7,231.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $138.18 / $634.24
| Professional | | $57.54 | $138.18 | $634.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.60 / $77.48 / $139.33
| Facility | | $59.60 | $77.48 | $139.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.53 / $152.29 / $331.31
| Professional | | $81.53 | $152.29 | $331.31 |
- 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
- $80.62 / $147.32 / $290.95
| Professional | | $80.62 | $147.32 | $290.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.51 / $168.26 / $6,679.00
| Facility | | $59.51 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.29 / $129.25 / $231.10
| Professional | | $102.29 | $129.25 | $231.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.98 / $135.65 / $239.51
| Professional | | $62.98 | $135.65 | $239.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.44 / $75.44 / $75.44
| Professional | | $75.44 | $75.44 | $75.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $399.70 / $2,028.00 / $11,500.00
| Facility | | $399.70 | $2,028.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.52 / $226.76 / $634.24
| Professional | | $102.52 | $226.76 | $634.24 |
- 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
- $88.17 / $137.86 / $289.94
| Professional | | $88.17 | $137.86 | $289.94 |