- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.43 / $49.89 / $159.19
| Facility | | $27.43 | $49.89 | $159.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.43 / $42.23 / $88.45
| Professional | | $27.43 | $42.23 | $88.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.74 / $130.15 / $818.35
| Facility | | $47.74 | $130.15 | $818.35 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $13.02 / $13.02 / $13.02
| Facility | AS | $13.02 | $13.02 | $13.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.33 / $58.42 / $190.31
| Professional | | $29.33 | $58.42 | $190.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.61 / $529.41 / $714.39
| Facility | | $38.61 | $529.41 | $714.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.62 / $53.06 / $83.83
| Professional | | $25.62 | $53.06 | $83.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.36 / $53.08 / $141.38
| Professional | | $23.36 | $53.08 | $141.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.14 / $54.96 / $8,090.00
| Facility | | $31.14 | $54.96 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.09 / $53.21 / $85.14
| Professional | | $31.09 | $53.21 | $85.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $70.40 / $145.90
| Professional | | $32.36 | $70.40 | $145.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.16 / $154.16 / $158.10
| Facility | | $154.16 | $154.16 | $158.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.20 / $59.20 / $59.20
| Professional | | $59.20 | $59.20 | $59.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.15 / $130.15 / $130.15
| Facility | | $130.15 | $130.15 | $130.15 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $13.02 / $13.02 / $13.02
| Facility | AS | $13.02 | $13.02 | $13.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.98 / $59.33 / $318.22
| Professional | | $41.98 | $59.33 | $318.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.52 / $55.09 / $86.54
| Professional | | $41.52 | $55.09 | $86.54 |