- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.78 / $3,100.00 / $9,661.00
| Facility | | $32.78 | $3,100.00 | $9,661.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.16 / $46.32 / $93.13
| Professional | | $26.16 | $46.32 | $93.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,691.00 / $3,333.00 / $4,636.00
| Facility | | $1,691.00 | $3,333.00 | $4,636.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.09 / $58.22 / $121.30
| Professional | | $46.09 | $58.22 | $121.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $46.77 / $46.77
| Facility | | $46.77 | $46.77 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $46.77 / $71.59
| Professional | | $46.77 | $46.77 | $71.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.66 / $43.66 / $7,227.90
| Facility | | $43.66 | $43.66 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.42 / $46.42 / $46.42
| Professional | | $46.42 | $46.42 | $46.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.00 / $43.25 / $332.00
| Facility | | $25.00 | $43.25 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.03 / $71.68 / $104.88
| Professional | | $60.03 | $71.68 | $104.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.48 / $60.50 / $104.85
| Professional | | $42.48 | $60.50 | $104.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.66 / $555.00 / $7,227.90
| Facility | | $43.66 | $555.00 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.42 / $50.46 / $126.63
| Professional | | $46.42 | $50.46 | $126.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,079.00 / $2,826.00 / $4,851.00
| Facility | | $1,079.00 | $2,826.00 | $4,851.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.87 / $61.60 / $141.68
| Professional | | $43.87 | $61.60 | $141.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.52 / $35.52 / $35.52
| Facility | | $35.52 | $35.52 | $35.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.52 / $60.50 / $104.85
| Professional | | $35.52 | $60.50 | $104.85 |