- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.85 / $62.01 / $9,172.79
| Facility | | $27.85 | $62.01 | $9,172.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.85 / $28.97 / $3,576.69
| Professional | | $27.85 | $28.97 | $3,576.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.20 / $29.65 / $8,639.91
| Facility | | $25.20 | $29.65 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.36 / $28.36 / $28.36
| Professional | | $28.36 | $28.36 | $28.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.17 / $27.85 / $27.85
| Facility | | $22.17 | $27.85 | $27.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.85 / $27.85 / $27.85
| Professional | | $27.85 | $27.85 | $27.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.53 / $81.72 / $283.35
| Facility | | $45.53 | $81.72 | $283.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.77 / $65.05 / $9,172.79
| Facility | | $26.77 | $65.05 | $9,172.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.77 / $32.02 / $2,384.46
| Professional | | $26.77 | $32.02 | $2,384.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.17 / $27.85 / $27.85
| Facility | | $22.17 | $27.85 | $27.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.85 / $27.85 / $27.85
| Professional | | $27.85 | $27.85 | $27.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.68 / $32.68 / $37.92
| Facility | | $32.68 | $32.68 | $37.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.68 / $32.68 / $37.92
| Professional | | $32.68 | $32.68 | $37.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.50 / $26.50 / $32.33
| Facility | | $26.50 | $26.50 | $32.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.85 / $30.64 / $48.00
| Professional | | $27.85 | $30.64 | $48.00 |