- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.34 / $1,486.00 / $7,920.26
| Facility | | $70.34 | $1,486.00 | $7,920.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.24 / $54.31 / $109.78
| Professional | | $33.24 | $54.31 | $109.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $736.00 / $736.00 / $736.00
| Facility | | $736.00 | $736.00 | $736.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.70 / $86.44 / $121.93
| Professional | | $50.70 | $86.44 | $121.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.37 / $85.11 / $107.15
| Professional | | $70.37 | $85.11 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.98 / $74.68 / $130.46
| Facility | | $46.98 | $74.68 | $130.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.73 / $77.58 / $108.21
| Professional | | $57.73 | $77.58 | $108.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.80 / $87.54 / $107.20
| Facility | | $58.80 | $87.54 | $107.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.98 / $75.73 / $125.48
| Facility | | $46.98 | $75.73 | $125.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.15 / $85.43 / $118.56
| Professional | | $65.15 | $85.43 | $118.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $754.67 / $945.34 / $1,182.96
| Facility | | $754.67 | $945.34 | $1,182.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.36 / $89.76 / $124.12
| Professional | | $63.36 | $89.76 | $124.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $376.00 / $3,290.00 / $6,216.00
| Facility | | $376.00 | $3,290.00 | $6,216.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.58 / $95.47 / $135.71
| Professional | | $66.58 | $95.47 | $135.71 |