- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $1,819.70 / $3,715.35
| Facility | | $38.90 | $1,819.70 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $70.79 / $213.80
| Professional | | $19.05 | $70.79 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $562.34 / $2,818.38
| Facility | | $52.48 | $562.34 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $64.57 / $239.88
| Professional | | $22.91 | $64.57 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.12 / $25.12 / $57.54
| Facility | | $25.12 | $25.12 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.99 / $42.66 / $141.25
| Professional | | $23.99 | $42.66 | $141.25 |
- 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
- $24.55 / $66.07 / $204.17
| Professional | | $24.55 | $66.07 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.99 / $83.18 / $7,079.46
| Facility | | $23.99 | $83.18 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $112.20 / $162.18
| Professional | | $87.10 | $112.20 | $162.18 |
- 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
- $23.99 / $83.18 / $208.93
| Professional | | $23.99 | $83.18 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $263.03 / $331.13
| Facility | | $186.21 | $263.03 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $562.34 / $2,818.38
| Facility | | $52.48 | $562.34 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $64.57 / $245.47
| Professional | | $22.91 | $64.57 | $245.47 |
- 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
- $26.30 / $58.88 / $181.97
| Professional | | $26.30 | $58.88 | $181.97 |