- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.31 / $189.04 / $290.75
| Facility | | $56.31 | $189.04 | $290.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.31 / $71.26 / $350.00
| Professional | | $56.31 | $71.26 | $350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.12 / $311.81 / $8,639.91
| Facility | | $240.12 | $311.81 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.23 / $54.23 / $54.23
| Professional | | $54.23 | $54.23 | $54.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.55 / $90.38 / $203.36
| Facility | | $46.55 | $90.38 | $203.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.58 / $80.12 / $100.15
| Professional | | $51.58 | $80.12 | $100.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.98 / $41.02 / $94.13
| Professional | | $31.98 | $41.02 | $94.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.00 / $85.00 / $85.00
| Professional | | $85.00 | $85.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.09 / $177.27 / $287.12
| Facility | | $59.09 | $177.27 | $287.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.23 / $71.79 / $350.00
| Professional | | $54.23 | $71.79 | $350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.58 / $107.65 / $230.36
| Facility | | $48.58 | $107.65 | $230.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.73 / $80.12 / $100.15
| Professional | | $66.73 | $80.12 | $100.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.52 / $69.52 / $76.47
| Facility | | $69.52 | $69.52 | $76.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.18 / $69.52 / $76.47
| Professional | | $61.18 | $69.52 | $76.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.20 / $41.71 / $127.22
| Professional | | $29.20 | $41.71 | $127.22 |