- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.51 / $39.65 / $1,193.01
| Facility | | $36.51 | $39.65 | $1,193.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.51 / $40.22 / $49.92
| Professional | | $36.51 | $40.22 | $49.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.43 / $57.40 / $80.59
| Professional | | $35.43 | $57.40 | $80.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.56 / $56.72 / $90.53
| Professional | | $40.56 | $56.72 | $90.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.91 / $60.46 / $61.41
| Professional | | $45.91 | $60.46 | $61.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.93 / $164.93 / $1,211.83
| Facility | | $164.93 | $164.93 | $1,211.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.65 / $39.65 / $1,193.01
| Facility | | $39.65 | $39.65 | $1,193.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.51 / $40.57 / $71.76
| Professional | | $36.51 | $40.57 | $71.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.20 / $85.10 / $101.10
| Professional | | $70.20 | $85.10 | $101.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.68 / $59.04 / $93.58
| Professional | | $41.68 | $59.04 | $93.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.79 / $37.79 / $37.79
| Facility | | $37.79 | $37.79 | $37.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.79 / $37.79 / $37.79
| Professional | | $37.79 | $37.79 | $37.79 |
- 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
- $40.64 / $51.54 / $85.24
| Professional | | $40.64 | $51.54 | $85.24 |