- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.16 / $58.97 / $37,011.76
| Facility | | $42.16 | $58.97 | $37,011.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.16 / $42.16 / $50.64
| Professional | | $42.16 | $42.16 | $50.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.70 / $112.99 / $210.80
| Facility | | $35.70 | $112.99 | $210.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.16 / $42.16 / $4,110.43
| Professional | | $42.16 | $42.16 | $4,110.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.20 / $51.77 / $100.59
| Facility | | $45.20 | $51.77 | $100.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.21 / $69.34 / $87.55
| Professional | | $50.21 | $69.34 | $87.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.97 / $42.16 / $42.16
| Facility | | $40.97 | $42.16 | $42.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.16 / $42.16 / $43.70
| Professional | | $42.16 | $42.16 | $43.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.69 / $83.43 / $8,090.00
| Facility | | $42.69 | $83.43 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.16 / $42.16 / $42.16
| Professional | | $42.16 | $42.16 | $42.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.16 / $42.16 / $48.80
| Professional | | $42.16 | $42.16 | $48.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,034.90 / $6,507.35 / $8,861.08
| Facility | | $2,034.90 | $6,507.35 | $8,861.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $210.80 / $210.80
| Facility | | $75.00 | $210.80 | $210.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.16 / $44.69 / $4,110.43
| Professional | | $42.16 | $44.69 | $4,110.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.17 / $32.09 / $46.11
| Facility | | $29.17 | $32.09 | $46.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.53 / $42.16 / $63.24
| Professional | | $40.53 | $42.16 | $63.24 |