- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $1,380.38 / $3,630.78
| Facility | | $85.11 | $1,380.38 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $77.62 / $338.84
| Professional | | $25.12 | $77.62 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $309.03 / $2,818.38
| Facility | | $56.23 | $309.03 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.54 / $64.57 / $165.96
| Professional | | $27.54 | $64.57 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $67.61
| Facility | | $28.84 | $28.84 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $66.07 / $154.88
| Professional | | $28.84 | $66.07 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $67.61 / $144.54
| Professional | | $29.51 | $67.61 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.54 / $177.83 / $7,079.46
| Facility | | $27.54 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $83.18 / $120.23
| Professional | | $64.57 | $83.18 | $120.23 |
- 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
- $25.70 / $61.66 / $151.36
| Professional | | $25.70 | $61.66 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $263.03 / $870.96
| Facility | | $154.88 | $263.03 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $109.65 / $190.55
| Professional | | $77.62 | $109.65 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $199.53 / $2,818.38
| Facility | | $56.23 | $199.53 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.54 / $64.57 / $165.96
| Professional | | $27.54 | $64.57 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $2,818.38
| Facility | | $630.96 | $1,862.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $64.57 / $134.90
| Professional | | $28.84 | $64.57 | $134.90 |