- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.07 / $148.58 / $360.00
| Facility | | $32.07 | $148.58 | $360.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.18 / $33.77 / $65.76
| Professional | | $30.18 | $33.77 | $65.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.64 / $22.64 / $22.64
| Professional | | $22.64 | $22.64 | $22.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.24 / $247.04 / $8,639.91
| Facility | | $190.24 | $247.04 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.43 / $29.43 / $29.43
| Professional | | $29.43 | $29.43 | $29.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.80 / $50.23 / $124.96
| Facility | | $24.80 | $50.23 | $124.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.61 / $43.37 / $66.01
| Professional | | $23.61 | $43.37 | $66.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.14 / $22.26 / $51.09
| Professional | | $16.14 | $22.26 | $51.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.95 / $93.33 / $226.95
| Facility | | $47.95 | $93.33 | $226.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.64 / $32.07 / $36.00
| Professional | | $22.64 | $32.07 | $36.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.07 / $115.45 / $352.17
| Facility | | $32.07 | $115.45 | $352.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.81 / $33.95 / $95.24
| Professional | | $29.81 | $33.95 | $95.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.26 / $57.30 / $124.96
| Facility | | $25.26 | $57.30 | $124.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.61 / $43.37 / $66.01
| Professional | | $23.61 | $43.37 | $66.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.72 / $37.72 / $37.72
| Facility | | $37.72 | $37.72 | $37.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.20 / $37.72 / $49.01
| Professional | | $33.20 | $37.72 | $49.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $23.39 / $69.05
| Professional | | $15.85 | $23.39 | $69.05 |