- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $81.28 / $151.36
| Professional | | $64.57 | $81.28 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,344.23 / $3,162.28
| Facility | | $2,238.72 | $2,344.23 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $95.50 / $144.54
| Professional | | $57.54 | $95.50 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $100.00 / $151.36
| Professional | | $85.11 | $100.00 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $85.11 / $112.20
| Professional | | $70.79 | $85.11 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $93.33 / $190.55
| Professional | | $66.07 | $93.33 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $93.33 / $120.23
| Professional | | $70.79 | $93.33 | $120.23 |