- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.42 / $123.70 / $3,551.11
| Facility | | $70.42 | $123.70 | $3,551.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.77 / $66.23 / $99.27
| Professional | | $56.77 | $66.23 | $99.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.90 / $69.42 / $160.88
| Professional | | $66.90 | $69.42 | $160.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.73 / $287.82 / $4,206.46
| Facility | | $77.73 | $287.82 | $4,206.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.12 / $82.05 / $142.38
| Professional | | $49.12 | $82.05 | $142.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.93 / $97.93 / $110.28
| Professional | | $97.93 | $97.93 | $110.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.42 / $128.87 / $1,345.12
| Facility | | $70.42 | $128.87 | $1,345.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.13 / $70.42 / $278.16
| Professional | | $60.13 | $70.42 | $278.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.73 / $261.23 / $4,206.46
| Facility | | $77.73 | $261.23 | $4,206.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.84 / $82.70 / $144.22
| Professional | | $50.84 | $82.70 | $144.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.25 / $65.52 / $65.52
| Facility | | $47.25 | $65.52 | $65.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.25 / $65.52 / $71.58
| Professional | | $47.25 | $65.52 | $71.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.43 / $77.92 / $125.02
| Professional | | $47.43 | $77.92 | $125.02 |