- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.83 / $1,202.26 / $1,698.24
| Facility | | $0.83 | $1,202.26 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $72.44 / $457.09
| Professional | | $42.66 | $72.44 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $114.82 / $239.88
| Professional | | $58.88 | $114.82 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $186.21 / $295.12
| Facility | | $158.49 | $186.21 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $128.82 / $181.97
| Professional | | $83.18 | $128.82 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $120.23 / $4,265.80
| Facility | | $51.29 | $120.23 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $134.90 / $177.83
| Professional | | $104.71 | $134.90 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $912.01 / $1,778.28
| Facility | | $51.29 | $912.01 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $112.20 / $371.54
| Professional | | $61.66 | $112.20 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $138.04 / $208.93
| Professional | | $67.61 | $138.04 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $128.82 / $309.03
| Facility | | $128.82 | $128.82 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $141.25 / $436.52
| Professional | | $47.86 | $141.25 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $186.21 / $245.47
| Professional | | $83.18 | $186.21 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,584.89 / $1,949.84
| Facility | | $1,023.29 | $1,584.89 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $89.13 / $213.80
| Professional | | $52.48 | $89.13 | $213.80 |