- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.40 / $288.82 / $788.66
| Facility | | $3.40 | $288.82 | $788.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.40 / $14.33 / $33.65
| Professional | | $3.40 | $14.33 | $33.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.20 / $368.60 / $632.00
| Professional | | $299.20 | $368.60 | $632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.08 / $30.08 / $30.08
| Facility | | $30.08 | $30.08 | $30.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.08 / $30.08 / $30.08
| Professional | | $30.08 | $30.08 | $30.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.32 / $19.82 / $23.49
| Facility | | $17.32 | $19.82 | $23.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.32 / $17.32 / $17.32
| Professional | | $17.32 | $17.32 | $17.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38,249.62 / $38,249.62 / $38,249.62
| Professional | | $38,249.62 | $38,249.62 | $38,249.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.47 / $44.47 / $44.47
| Professional | | $44.47 | $44.47 | $44.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.60 / $24.59 / $206.99
| Facility | | $20.60 | $24.59 | $206.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.32 / $19.82 / $597.00
| Facility | | $17.32 | $19.82 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.32 / $17.32 / $17.32
| Professional | | $17.32 | $17.32 | $17.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.38 / $20.38 / $29.46
| Professional | | $20.38 | $20.38 | $29.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.47 / $47.06 / $47.06
| Facility | | $44.47 | $47.06 | $47.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.47 / $44.47 / $47.06
| Professional | | $44.47 | $44.47 | $47.06 |