- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $131.83 / $229.09
| Facility | | $50.12 | $131.83 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $46.77 / $223.87
| Professional | | $26.92 | $46.77 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $70.79 / $239.88
| Facility | | $45.71 | $70.79 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $50.12 / $107.15
| Professional | | $29.51 | $50.12 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $123.03 / $199.53
| Facility | | $100.00 | $123.03 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $47.86 / $64.57
| Professional | | $47.86 | $47.86 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $77.62 / $190.55
| Facility | | $39.81 | $77.62 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $61.66 / $100.00
| Professional | | $33.88 | $61.66 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,630.78 / $9,772.37
| Facility | | $56.23 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $72.44 / $85.11
| Professional | | $72.44 | $72.44 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $154.88
| Professional | | $50.12 | $50.12 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $70.79 / $239.88
| Facility | | $45.71 | $70.79 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $50.12 / $107.15
| Professional | | $29.51 | $50.12 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $50.12 / $83.18
| Facility | | $28.84 | $50.12 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $42.66 / $120.23
| Professional | | $25.12 | $42.66 | $120.23 |