- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.00 / $62.12 / $7,854.00
| Facility | | $27.00 | $62.12 | $7,854.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.00 / $27.27 / $2,808.00
| Professional | | $27.00 | $27.27 | $2,808.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.44 / $28.75 / $8,639.91
| Facility | | $24.44 | $28.75 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.50 / $27.50 / $28.75
| Professional | | $27.50 | $27.50 | $28.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.65 / $27.00 / $27.00
| Facility | | $24.65 | $27.00 | $27.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.00 / $27.00 / $27.00
| Professional | | $27.00 | $27.00 | $27.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.38 / $32.38 / $80.31
| Facility | | $32.38 | $32.38 | $80.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.30 / $62.12 / $5,852.00
| Facility | | $25.30 | $62.12 | $5,852.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.30 / $29.53 / $2,265.94
| Professional | | $25.30 | $29.53 | $2,265.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.65 / $27.00 / $27.00
| Facility | | $24.65 | $27.00 | $27.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.00 / $27.00 / $27.00
| Professional | | $27.00 | $27.00 | $27.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.47 / $45.47 / $52.76
| Facility | | $45.47 | $45.47 | $52.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.47 / $45.47 / $52.76
| Professional | | $45.47 | $45.47 | $52.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.05 / $25.05 / $25.05
| Facility | | $25.05 | $25.05 | $25.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.00 / $27.00 / $46.53
| Professional | | $27.00 | $27.00 | $46.53 |