- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $35.48 / $79.43
| Facility | | $7.08 | $35.48 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $37.15 / $100.00
| Professional | | $34.67 | $37.15 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $25.12 / $28.18
| Professional | | $25.12 | $25.12 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $37.15 / $40.74
| Facility | | $37.15 | $37.15 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $37.15 / $37.15
| Professional | | $37.15 | $37.15 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $54.95 / $50,118.72
| Facility | | $25.70 | $54.95 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $25.70 / $199.53
| Professional | | $25.70 | $25.70 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $69.18 / $120.23
| Facility | | $69.18 | $69.18 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $64.57 / $81.28
| Professional | | $64.57 | $64.57 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.98 / $48.98 / $72.44
| Facility | | $48.98 | $48.98 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $48.98 / $72.44
| Professional | | $48.98 | $48.98 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.39 / $38.02 / $39.81
| Facility | | $3.39 | $38.02 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $50,118.72 / $75,857.76
| Facility | | $81.28 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $48.98 / $75.86
| Professional | | $25.12 | $48.98 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.98 / $48.98 / $72.44
| Facility | | $48.98 | $48.98 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $58.88 / $72.44
| Professional | | $48.98 | $58.88 | $72.44 |