- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.23 / $125.00 / $165.49
| Facility | | $94.23 | $125.00 | $165.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.29 / $56.50 / $125.00
| Professional | | $35.29 | $56.50 | $125.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.47 / $257.93 / $2,360.08
| Facility | | $63.47 | $257.93 | $2,360.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.58 / $54.30 / $132.26
| Professional | | $32.58 | $54.30 | $132.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.12 / $133.33 / $220.30
| Facility | | $88.12 | $133.33 | $220.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.04 / $51.04 / $87.98
| Professional | | $51.04 | $51.04 | $87.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.69 / $58.75 / $105.88
| Facility | | $35.69 | $58.75 | $105.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.76 / $54.30 / $242.84
| Professional | | $19.76 | $54.30 | $242.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.42 / $78.42 / $92.26
| Professional | | $78.42 | $78.42 | $92.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.30 / $71.68 / $176.48
| Professional | | $54.30 | $71.68 | $176.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.59 / $58.56 / $146.34
| Facility | | $51.59 | $58.56 | $146.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.48 / $257.93 / $257.93
| Facility | | $94.48 | $257.93 | $257.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.72 / $32.58 / $95.03
| Professional | | $21.72 | $32.58 | $95.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.87 / $54.30 / $65.16
| Facility | | $48.87 | $54.30 | $65.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.72 / $32.58 / $81.45
| Professional | | $21.72 | $32.58 | $81.45 |