- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.32 / $170.65 / $268.27
| Facility | | $58.32 | $170.65 | $268.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.90 / $33.77 / $107.69
| Professional | | $12.90 | $33.77 | $107.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.16 / $502.00 / $2,922.50
| Facility | | $28.16 | $502.00 | $2,922.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.54 / $26.72 / $804.00
| Professional | | $11.54 | $26.72 | $804.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.31 / $24.77 / $60.73
| Professional | | $11.31 | $24.77 | $60.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.09 / $83.43 / $8,090.00
| Facility | | $14.09 | $83.43 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.30 / $13.59 / $23.51
| Professional | | $7.30 | $13.59 | $23.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.34 / $28.43 / $37.65
| Professional | | $14.34 | $28.43 | $37.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.06 / $97.89 / $119.07
| Facility | | $57.06 | $97.89 | $119.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.96 / $19.93 / $35.79
| Professional | | $13.96 | $19.93 | $35.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,790.00 / $2,922.50
| Facility | | $55.00 | $1,790.00 | $2,922.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.54 / $28.45 / $804.00
| Professional | | $12.54 | $28.45 | $804.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.59 / $71.95 / $157.80
| Facility | | $13.59 | $71.95 | $157.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.70 / $17.88 / $25.39
| Professional | | $11.70 | $17.88 | $25.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,790.00 / $2,733.00
| Facility | | $627.00 | $1,790.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.54 / $25.12 / $41.77
| Professional | | $12.54 | $25.12 | $41.77 |