- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.96 / $1,886.00 / $3,625.00
| Facility | | $48.96 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.37 / $55.29 / $131.88
| Professional | | $41.37 | $55.29 | $131.88 |
- 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
- $42.12 / $92.48 / $389.19
| Professional | | $42.12 | $92.48 | $389.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.76 / $59.49 / $104.97
| Facility | | $45.76 | $59.49 | $104.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.41 / $75.04 / $155.34
| Professional | | $43.41 | $75.04 | $155.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.15 / $92.65 / $184.79
| Professional | | $56.15 | $92.65 | $184.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.79 / $83.44 / $8,090.00
| Facility | | $46.79 | $83.44 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.38 / $56.54 / $91.15
| Professional | | $30.38 | $56.54 | $91.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.80 / $104.88 / $141.19
| Professional | | $50.80 | $104.88 | $141.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.86 / $525.32 / $595.66
| Facility | | $72.86 | $525.32 | $595.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.80 / $72.14 / $156.74
| Professional | | $54.80 | $72.14 | $156.74 |
- 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
- $65.84 / $118.94 / $389.19
| Professional | | $65.84 | $118.94 | $389.19 |
- 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
- $58.22 / $78.86 / $165.19
| Professional | | $58.22 | $78.86 | $165.19 |