- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.65 / $1,823.00 / $3,625.00
| Facility | | $38.65 | $1,823.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.46 / $45.98 / $216.95
| Professional | | $29.46 | $45.98 | $216.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $736.00 / $2,796.00
| Facility | | $55.00 | $736.00 | $2,796.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.92 / $67.63 / $515.92
| Professional | | $30.92 | $67.63 | $515.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.64 / $42.43 / $74.88
| Facility | | $32.64 | $42.43 | $74.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.96 / $53.52 / $117.99
| Professional | | $30.96 | $53.52 | $117.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.92 / $67.88 / $134.30
| Professional | | $40.92 | $67.88 | $134.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.65 / $168.26 / $6,679.00
| Facility | | $33.65 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.07 / $44.13 / $69.02
| Professional | | $23.07 | $44.13 | $69.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.11 / $76.64 / $103.93
| Professional | | $36.11 | $76.64 | $103.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.57 / $378.84 / $579.22
| Facility | | $82.57 | $378.84 | $579.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.75 / $61.04 / $270.97
| Professional | | $46.75 | $61.04 | $270.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.71 / $90.86 / $515.92
| Professional | | $49.71 | $90.86 | $515.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.47 / $60.69 / $130.88
| Professional | | $44.47 | $60.69 | $130.88 |