- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.31 / $79.36 / $14,482.00
| Facility | | $46.31 | $79.36 | $14,482.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.22 / $46.31 / $140.21
| Professional | | $33.22 | $46.31 | $140.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.70 / $97.38 / $176.10
| Professional | | $38.70 | $97.38 | $176.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.02 / $116.89 / $188.53
| Facility | | $100.02 | $116.89 | $188.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.15 / $115.20 / $132.63
| Professional | | $60.15 | $115.20 | $132.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.79 / $51.16 / $76.73
| Facility | | $38.79 | $51.16 | $76.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.32 / $1,716.00 / $7,700.00
| Facility | | $42.32 | $1,716.00 | $7,700.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.91 / $100.22 / $198.12
| Professional | | $46.91 | $100.22 | $198.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.49 / $58.40 / $120.01
| Professional | | $27.49 | $58.40 | $120.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.79 / $51.16 / $76.73
| Facility | | $38.79 | $51.16 | $76.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.25 / $112.35 / $141.94
| Professional | | $81.25 | $112.35 | $141.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $1,300.00 / $1,300.00
| Facility | | $1,300.00 | $1,300.00 | $1,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.43 / $193.70 / $298.00
| Professional | | $56.43 | $193.70 | $298.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.00 / $72.00 / $72.00
| Professional | | $72.00 | $72.00 | $72.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.68 / $121.41 / $187.90
| Professional | | $80.68 | $121.41 | $187.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,203.00 / $4,316.80 / $19,003.00
| Facility | | $2,203.00 | $4,316.80 | $19,003.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.66 / $117.53 / $169.78
| Professional | | $47.66 | $117.53 | $169.78 |