- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.04 / $94.58 / $24,451.58
| Facility | | $34.04 | $94.58 | $24,451.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.04 / $37.02 / $6,958.80
| Professional | | $34.04 | $37.02 | $6,958.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.40 / $36.94 / $8,639.91
| Facility | | $31.40 | $36.94 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.33 / $35.33 / $35.33
| Professional | | $35.33 | $35.33 | $35.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.11 / $34.04 / $34.04
| Facility | | $32.11 | $34.04 | $34.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.04 / $34.04 / $34.04
| Professional | | $34.04 | $34.04 | $34.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.70 / $125.73 / $297.95
| Facility | | $85.70 | $125.73 | $297.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.02 / $111.45 / $24,451.63
| Facility | | $37.02 | $111.45 | $24,451.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.04 / $44.36 / $6,958.80
| Professional | | $34.04 | $44.36 | $6,958.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.11 / $34.04 / $34.04
| Facility | | $32.11 | $34.04 | $34.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.04 / $34.04 / $34.04
| Professional | | $34.04 | $34.04 | $34.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.56 / $61.56 / $71.43
| Facility | | $61.56 | $61.56 | $71.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.56 / $61.56 / $71.43
| Professional | | $61.56 | $61.56 | $71.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.04 / $34.04 / $62.31
| Professional | | $34.04 | $34.04 | $62.31 |