- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.38 / $57.99 / $18,209.37
| Facility | | $29.38 | $57.99 | $18,209.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.38 / $30.55 / $16,520.00
| Professional | | $29.38 | $30.55 | $16,520.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.32 / $78.73 / $344.00
| Facility | | $32.32 | $78.73 | $344.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.38 / $45.10 / $86.25
| Professional | | $29.38 | $45.10 | $86.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.52 / $37.49 / $79.91
| Facility | | $31.52 | $37.49 | $79.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.38 / $29.38 / $31.83
| Facility | | $29.38 | $29.38 | $31.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.38 / $29.38 / $29.38
| Professional | | $29.38 | $29.38 | $29.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.80 / $62.36 / $8,090.00
| Facility | | $31.80 | $62.36 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.94 / $49.94 / $58.75
| Professional | | $49.94 | $49.94 | $58.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.38 / $29.38 / $119.89
| Professional | | $29.38 | $29.38 | $119.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.81 / $945.38 / $8,624.95
| Facility | | $141.81 | $945.38 | $8,624.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.47 / $101.47 / $344.00
| Facility | | $101.47 | $101.47 | $344.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.55 / $45.10 / $86.25
| Professional | | $42.55 | $45.10 | $86.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.22 / $53.17 / $84.20
| Facility | | $45.22 | $53.17 | $84.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.55 / $45.10 / $86.25
| Professional | | $42.55 | $45.10 | $86.25 |