- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.09 / $82.32 / $9,806.40
| Facility | | $31.09 | $82.32 | $9,806.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.09 / $1,501.44 / $11,310.94
| Professional | | $31.09 | $1,501.44 | $11,310.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.67 / $33.72 / $8,639.91
| Facility | | $28.67 | $33.72 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.26 / $32.26 / $33.72
| Professional | | $32.26 | $32.26 | $33.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.33 / $31.09 / $31.09
| Facility | | $29.33 | $31.09 | $31.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.09 / $31.09 / $31.09
| Professional | | $31.09 | $31.09 | $31.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.64 / $38.04 / $94.43
| Facility | | $37.64 | $38.04 | $94.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.49 / $94.79 / $19,731.93
| Facility | | $31.49 | $94.79 | $19,731.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.09 / $94.79 / $9,969.29
| Professional | | $31.09 | $94.79 | $9,969.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,843.16 / $2,638.16 / $8,905.16
| Facility | | $1,843.16 | $2,638.16 | $8,905.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.33 / $31.09 / $31.09
| Facility | | $29.33 | $31.09 | $31.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.09 / $31.09 / $31.09
| Professional | | $31.09 | $31.09 | $31.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.86 / $34.86 / $40.45
| Facility | | $34.86 | $34.86 | $40.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.86 / $34.86 / $40.45
| Professional | | $34.86 | $34.86 | $40.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.09 / $31.09 / $65.84
| Professional | | $31.09 | $31.09 | $65.84 |