- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.98 / $5,116.62 / $22,024.00
| Facility | | $5.98 | $5,116.62 | $22,024.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.05 / $18.03 / $36.22
| Professional | | $6.05 | $18.03 | $36.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $169.50 / $331.58
| Facility | | $75.00 | $169.50 | $331.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.56 / $37.90 / $148.66
| Professional | | $10.56 | $37.90 | $148.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.43 / $21.43 / $21.43
| Professional | | $21.43 | $21.43 | $21.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.89 / $26.92 / $60.88
| Facility | | $10.89 | $26.92 | $60.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.00 / $21.79 / $60.19
| Professional | | $11.00 | $21.79 | $60.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $50.31 / $90.97
| Professional | | $9.12 | $50.31 | $90.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.96 / $43.55 / $48.24
| Facility | | $24.96 | $43.55 | $48.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.26 / $31.26 / $32.90
| Facility | | $31.26 | $31.26 | $32.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.56 / $24.46 / $58.90
| Professional | | $10.56 | $24.46 | $58.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.40 / $173.34 / $331.58
| Facility | | $112.40 | $173.34 | $331.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.16 / $24.17 / $54.68
| Professional | | $10.16 | $24.17 | $54.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.00 / $588.00 / $5,793.00
| Facility | | $140.00 | $588.00 | $5,793.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.40 / $34.84 / $67.58
| Professional | | $26.40 | $34.84 | $67.58 |