- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.86 / $65.86 / $9,775.00
| Facility | | $65.86 | $65.86 | $9,775.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.11 / $57.97 / $230.00
| Professional | | $48.11 | $57.97 | $230.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.53 / $85.99 / $116.78
| Professional | | $44.53 | $85.99 | $116.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.50 / $76.30 / $110.31
| Professional | | $54.50 | $76.30 | $110.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.65 / $72.65 / $78.42
| Professional | | $72.65 | $72.65 | $78.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,473.21 / $1,473.21 / $1,473.21
| Facility | | $1,473.21 | $1,473.21 | $1,473.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.86 / $1,812.00 / $9,775.00
| Facility | | $65.86 | $1,812.00 | $9,775.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.09 / $62.86 / $230.00
| Professional | | $52.09 | $62.86 | $230.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.40 / $70.50 / $142.19
| Professional | | $59.40 | $70.50 | $142.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.77 / $76.65 / $117.63
| Professional | | $54.77 | $76.65 | $117.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.17 / $50.17 / $345.31
| Facility | | $50.17 | $50.17 | $345.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.25 / $50.83 / $345.31
| Professional | | $48.25 | $50.83 | $345.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $650.00 / $3,742.00
| Facility | | $144.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.15 / $75.12 / $121.81
| Professional | | $59.15 | $75.12 | $121.81 |