- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.06 / $3,659.00 / $8,134.00
| Facility | | $52.06 | $3,659.00 | $8,134.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.04 / $46.99 / $70.31
| Professional | | $34.04 | $46.99 | $70.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,393.00 / $4,120.00 / $8,836.00
| Facility | | $2,393.00 | $4,120.00 | $8,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.97 / $37.50 / $92.42
| Professional | | $28.97 | $37.50 | $92.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.17 / $1,254.00 / $4,050.00
| Facility | | $54.17 | $1,254.00 | $4,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.17 / $54.17 / $54.17
| Professional | | $54.17 | $54.17 | $54.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.10 / $43.10 / $3,479.91
| Facility | | $43.10 | $43.10 | $3,479.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.75 / $71.43 / $198.91
| Professional | | $37.75 | $71.43 | $198.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.72 / $70.00 / $332.00
| Facility | | $41.72 | $70.00 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.61 / $50.42 / $75.45
| Professional | | $41.61 | $50.42 | $75.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.02 / $45.20 / $68.08
| Professional | | $30.02 | $45.20 | $68.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.10 / $555.00 / $3,479.91
| Facility | | $43.10 | $555.00 | $3,479.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.98 / $67.05 / $153.47
| Professional | | $40.98 | $67.05 | $153.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,031.00 / $4,840.00 / $9,202.00
| Facility | | $2,031.00 | $4,840.00 | $9,202.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.42 / $46.26 / $119.11
| Professional | | $30.42 | $46.26 | $119.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.63 / $48.63 / $138.99
| Facility | | $48.63 | $48.63 | $138.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.02 / $48.63 / $79.43
| Professional | | $30.02 | $48.63 | $79.43 |