- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.33 / $90.33 / $168.38
| Facility | | $32.33 | $90.33 | $168.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.47 / $30.61 / $38.69
| Professional | | $26.47 | $30.61 | $38.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.96 / $59.06 / $175.00
| Facility | | $30.96 | $59.06 | $175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.29 / $33.94 / $82.67
| Professional | | $16.29 | $33.94 | $82.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.67 / $95.02 / $166.13
| Facility | | $59.67 | $95.02 | $166.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.90 / $31.90 / $43.42
| Professional | | $31.90 | $31.90 | $43.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.72 / $50.41 / $115.98
| Facility | | $23.72 | $50.41 | $115.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.39 / $37.53 / $57.40
| Professional | | $20.39 | $37.53 | $57.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.01 / $49.01 / $57.66
| Professional | | $49.01 | $49.01 | $57.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.94 / $47.04 / $126.33
| Professional | | $33.94 | $47.04 | $126.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.52 / $39.01 / $41.34
| Facility | | $30.52 | $39.01 | $41.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.06 / $175.00 / $175.00
| Facility | | $59.06 | $175.00 | $175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.65 / $20.36 / $71.66
| Professional | | $13.65 | $20.36 | $71.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.65 / $20.36 / $64.69
| Professional | | $13.65 | $20.36 | $64.69 |