- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.90 / $121.98 / $214.22
| Facility | | $36.90 | $121.98 | $214.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.48 / $73.50 / $159.00
| Professional | | $73.48 | $73.50 | $159.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.84 / $122.30 / $242.57
| Facility | | $71.84 | $122.30 | $242.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.17 / $70.29 / $278.74
| Professional | | $42.17 | $70.29 | $278.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.98 / $18.13 / $35.58
| Facility | | $11.98 | $18.13 | $35.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.98 / $11.98 / $11.98
| Professional | | $11.98 | $11.98 | $11.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.15 / $48.46 / $60.31
| Facility | | $46.15 | $48.46 | $60.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.63 / $102.59 / $136.94
| Professional | | $85.63 | $102.59 | $136.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.29 / $140.58 / $6,679.00
| Facility | | $70.29 | $140.58 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.67 / $98.41 / $149.72
| Professional | | $77.67 | $98.41 | $149.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.95 / $30.95 / $159.69
| Professional | | $30.95 | $30.95 | $159.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.30 / $333.88 / $333.88
| Facility | | $122.30 | $333.88 | $333.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.17 / $68.59 / $350.04
| Professional | | $42.17 | $68.59 | $350.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.77 / $66.77 / $70.29
| Professional | | $66.77 | $66.77 | $70.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.31 / $58.54 / $177.83
| Professional | | $31.31 | $58.54 | $177.83 |