- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $2,089.30 / $3,715.35
| Facility | | $37.15 | $2,089.30 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $58.88 / $190.55
| Professional | | $14.13 | $58.88 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $562.34 / $2,818.38
| Facility | | $37.15 | $562.34 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.22 / $48.98 / $208.93
| Professional | | $16.22 | $48.98 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $40.74
| Facility | | $17.38 | $17.38 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $44.67 / $186.21
| Professional | | $17.38 | $44.67 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $54.95 / $177.83
| Professional | | $17.38 | $54.95 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $83.18 / $7,079.46
| Facility | | $16.60 | $83.18 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $97.72 / $141.25
| Professional | | $75.86 | $97.72 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $72.44 / $181.97
| Professional | | $16.60 | $72.44 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $239.88 / $380.19
| Facility | | $128.82 | $239.88 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $562.34 / $2,818.38
| Facility | | $37.15 | $562.34 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.22 / $50.12 / $213.80
| Professional | | $16.22 | $50.12 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $43.65 / $158.49
| Professional | | $18.20 | $43.65 | $158.49 |