- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.71 / $169.17 / $1,078.00
| Facility | | $39.71 | $169.17 | $1,078.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.71 / $45.11 / $132.38
| Professional | | $39.71 | $45.11 | $132.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.23 / $321.05 / $8,639.91
| Facility | | $247.23 | $321.05 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.24 / $38.24 / $38.24
| Professional | | $38.24 | $38.24 | $38.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.22 / $65.29 / $162.99
| Facility | | $32.22 | $65.29 | $162.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.75 / $56.58 / $85.90
| Professional | | $30.75 | $56.58 | $85.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.55 / $28.93 / $66.39
| Professional | | $22.55 | $28.93 | $66.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.18 / $215.18 / $446.43
| Facility | | $95.18 | $215.18 | $446.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.00 / $47.00 / $47.00
| Professional | | $47.00 | $47.00 | $47.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.85 / $139.72 / $912.20
| Facility | | $45.85 | $139.72 | $912.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.77 / $44.46 / $202.49
| Professional | | $36.77 | $44.46 | $202.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.83 / $74.48 / $162.99
| Facility | | $32.83 | $74.48 | $162.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.75 / $56.58 / $85.90
| Professional | | $30.75 | $56.58 | $85.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.03 / $49.03 / $49.03
| Facility | | $49.03 | $49.03 | $49.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.15 / $49.03 / $69.78
| Professional | | $43.15 | $49.03 | $69.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.59 / $31.38 / $85.90
| Professional | | $20.59 | $31.38 | $85.90 |