- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.82 / $144.30 / $385.48
| Facility | | $32.82 | $144.30 | $385.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.89 / $27.62 / $36.95
| Professional | | $15.89 | $27.62 | $36.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.39 / $80.72 / $2,220.10
| Facility | | $20.39 | $80.72 | $2,220.10 |
- 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
- $26.86 / $27.87 / $48.66
| Professional | | $26.86 | $27.87 | $48.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.34 / $30.41 / $50.97
| Professional | | $15.34 | $30.41 | $50.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.91 / $41.83 / $43.33
| Professional | | $25.91 | $41.83 | $43.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.50 / $147.60 / $434.71
| Facility | | $43.50 | $147.60 | $434.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.06 / $83.82 / $1,455.35
| Facility | | $26.06 | $83.82 | $1,455.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.82 / $112.70 / $378.39
| Facility | | $26.82 | $112.70 | $378.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.89 / $27.62 / $46.63
| Professional | | $15.89 | $27.62 | $46.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.20 / $40.20 / $74.90
| Professional | | $32.20 | $40.20 | $74.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.05 / $30.49 / $49.27
| Professional | | $16.05 | $30.49 | $49.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.62 / $19.59 / $30.16
| Facility | | $14.62 | $19.59 | $30.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.62 / $26.18 / $28.36
| Professional | | $14.62 | $26.18 | $28.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.03 / $436.57 / $3,000.00
| Facility | | $172.03 | $436.57 | $3,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.31 / $35.92 / $58.45
| Professional | | $27.31 | $35.92 | $58.45 |