- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.38 / $1,544.00 / $6,012.00
| Facility | | $34.38 | $1,544.00 | $6,012.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.77 / $37.75 / $145.30
| Professional | | $25.77 | $37.75 | $145.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.63 / $50.63 / $50.63
| Professional | | $50.63 | $50.63 | $50.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.29 / $38.70 / $47.90
| Professional | | $37.29 | $38.70 | $47.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.75 / $45.22 / $72.26
| Professional | | $31.75 | $45.22 | $72.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.19 / $58.63 / $58.80
| Professional | | $44.19 | $58.63 | $58.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.16 / $143.16 / $143.16
| Facility | | $143.16 | $143.16 | $143.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.75 / $1,741.00 / $7,175.00
| Facility | | $43.75 | $1,741.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.62 / $45.73 / $150.47
| Professional | | $27.62 | $45.73 | $150.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.80 / $82.50 / $98.30
| Professional | | $66.80 | $82.50 | $98.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.22 / $45.69 / $75.06
| Professional | | $32.22 | $45.69 | $75.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.98 / $28.98 / $37.83
| Facility | | $28.98 | $28.98 | $37.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.98 / $36.69 / $40.06
| Professional | | $28.98 | $36.69 | $40.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $557.00 / $3,742.00
| Facility | | $162.00 | $557.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.95 / $48.29 / $76.72
| Professional | | $36.95 | $48.29 | $76.72 |