- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.17 / $1,934.00 / $6,386.00
| Facility | | $67.17 | $1,934.00 | $6,386.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.51 / $62.50 / $81.44
| Professional | | $51.51 | $62.50 | $81.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.37 / $290.66 / $656.74
| Facility | | $156.37 | $290.66 | $656.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.96 / $53.31 / $77.62
| Professional | | $42.96 | $53.31 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.48 / $213.36 / $2,522.69
| Facility | | $53.48 | $213.36 | $2,522.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.95 / $44.95 / $44.95
| Facility | | $44.95 | $44.95 | $44.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.58 / $71.92 / $115.52
| Professional | | $51.58 | $71.92 | $115.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $12,000.00 / $12,000.00
| Facility | | $2,000.00 | $12,000.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.18 / $659.20 / $680.96
| Professional | | $478.18 | $659.20 | $680.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.78 / $73.66 / $150.38
| Facility | | $53.78 | $73.66 | $150.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.57 / $78.69 / $92.57
| Professional | | $56.57 | $78.69 | $92.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.80 / $145.80 / $145.80
| Professional | | $145.80 | $145.80 | $145.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.78 / $73.87 / $150.38
| Facility | | $53.78 | $73.87 | $150.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.98 / $73.53 / $118.85
| Professional | | $52.98 | $73.53 | $118.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.78 / $931.00 / $2,290.00
| Facility | | $152.78 | $931.00 | $2,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.04 / $59.35 / $94.26
| Professional | | $43.04 | $59.35 | $94.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.89 / $50.45 / $69.42
| Professional | | $43.89 | $50.45 | $69.42 |