- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.41 / $27.41 / $1,060.80
| Facility | | $27.41 | $27.41 | $1,060.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.26 / $27.98 / $34.95
| Professional | | $25.26 | $27.98 | $34.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.51 / $40.14 / $55.68
| Professional | | $24.51 | $40.14 | $55.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.11 / $38.84 / $76.65
| Professional | | $28.11 | $38.84 | $76.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.78 / $41.87 / $42.46
| Professional | | $31.78 | $41.87 | $42.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.46 / $166.56 / $1,263.89
| Facility | | $110.46 | $166.56 | $1,263.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.41 / $978.40 / $1,060.80
| Facility | | $27.41 | $978.40 | $1,060.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.26 / $28.21 / $50.20
| Professional | | $25.26 | $28.21 | $50.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.60 / $40.90 / $70.00
| Professional | | $31.60 | $40.90 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.83 / $40.97 / $80.88
| Professional | | $28.83 | $40.97 | $80.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.15 / $26.15 / $26.15
| Facility | | $26.15 | $26.15 | $26.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.15 / $26.15 / $26.15
| Professional | | $26.15 | $26.15 | $26.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $577.00 / $3,742.00
| Facility | | $162.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.11 / $35.57 / $60.19
| Professional | | $28.11 | $35.57 | $60.19 |