- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,691.53 / $8,317.64
| Facility | | $831.76 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $45.71 / $70.79
| Professional | | $8.13 | $45.71 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $20.42 / $33.88
| Professional | | $17.38 | $20.42 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $33.88 / $40.74
| Professional | | $33.88 | $33.88 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $48.98 / $177.83
| Professional | | $48.98 | $48.98 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $54.95 / $186.21
| Professional | | $38.02 | $54.95 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,344.23 / $8,317.64
| Facility | | $660.69 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.51 / $45.71 / $707.95
| Professional | | $8.51 | $45.71 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $54.95 / $54.95
| Facility | | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $54.95 / $66.07
| Professional | | $54.95 | $54.95 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.54 / $27.54 / $33.88
| Facility | | $27.54 | $27.54 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $33.88 / $36.31
| Professional | | $15.85 | $33.88 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $524.81 / $3,890.45
| Facility | | $162.18 | $524.81 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $23.44 / $69.18
| Professional | | $17.38 | $23.44 | $69.18 |