- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.32 / $53.06 / $7,742.82
| Facility | | $30.32 | $53.06 | $7,742.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.32 / $31.54 / $33.59
| Professional | | $30.32 | $31.54 | $33.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.35 / $100.45 / $818.35
| Facility | | $33.35 | $100.45 | $818.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.32 / $32.14 / $333.67
| Professional | | $30.32 | $32.14 | $333.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.53 / $38.69 / $82.47
| Facility | | $32.53 | $38.69 | $82.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.71 / $30.32 / $30.32
| Facility | | $24.71 | $30.32 | $30.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.32 / $30.32 / $30.32
| Professional | | $30.32 | $30.32 | $30.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.32 / $55.98 / $8,090.00
| Facility | | $30.32 | $55.98 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.47 / $35.47 / $41.73
| Professional | | $35.47 | $35.47 | $41.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.32 / $30.32 / $62.97
| Professional | | $30.32 | $30.32 | $62.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.55 / $392.55 / $1,527.75
| Facility | | $392.55 | $392.55 | $1,527.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.32 / $32.14 / $333.67
| Professional | | $30.32 | $32.14 | $333.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.32 / $32.14 / $333.67
| Professional | | $30.32 | $32.14 | $333.67 |