- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $251.19 / $436.52
| Facility | | $77.62 | $251.19 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $107.15 / $245.47
| Professional | | $77.62 | $107.15 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $309.03 / $1,148.15
| Facility | | $93.33 | $309.03 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $144.54 / $741.31
| Professional | | $91.20 | $144.54 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $549.54 / $794.33
| Facility | | $436.52 | $549.54 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $724.44 / $1,819.70
| Facility | | $154.88 | $724.44 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $158.49 / $309.03
| Professional | | $85.11 | $158.49 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $131.83 / $8,511.38
| Facility | | $75.86 | $131.83 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $112.20 / $204.17
| Professional | | $34.67 | $112.20 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $162.18 / $302.00
| Professional | | $104.71 | $162.18 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $213.80
| Facility | | $213.80 | $213.80 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $309.03 / $1,148.15
| Facility | | $93.33 | $309.03 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $144.54 / $741.31
| Professional | | $93.33 | $144.54 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.66 / $489.78 / $1,000.00
| Facility | | $42.66 | $489.78 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $151.36 / $281.84
| Professional | | $107.15 | $151.36 | $281.84 |