- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.94 / $118.01 / $7,658.74
| Facility | | $50.94 | $118.01 | $7,658.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.74 / $61.02 / $8,112.00
| Professional | | $50.74 | $61.02 | $8,112.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.78 / $55.04 / $8,639.91
| Facility | | $46.78 | $55.04 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.65 / $52.65 / $55.05
| Professional | | $52.65 | $52.65 | $55.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.87 / $50.74 / $50.74
| Facility | | $47.87 | $50.74 | $50.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.74 / $50.74 / $50.74
| Professional | | $50.74 | $50.74 | $50.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.52 / $92.51 / $273.50
| Facility | | $61.52 | $92.51 | $273.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.94 / $125.07 / $15,699.00
| Facility | | $50.94 | $125.07 | $15,699.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.74 / $69.68 / $5,973.10
| Professional | | $50.74 | $69.68 | $5,973.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.87 / $50.74 / $50.74
| Facility | | $47.87 | $50.74 | $50.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.74 / $50.74 / $50.74
| Professional | | $50.74 | $50.74 | $50.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.57 / $47.57 / $55.20
| Facility | | $47.57 | $47.57 | $55.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.57 / $47.57 / $55.20
| Professional | | $47.57 | $47.57 | $55.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.74 / $56.83 / $87.45
| Professional | | $50.74 | $56.83 | $87.45 |