- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $3,981.07 / $8,317.64
| Facility | | $251.19 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $123.03 / $489.78
| Professional | | $46.77 | $123.03 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $112.20 / $204.17
| Professional | | $112.20 | $112.20 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,258.93 / $57,543.99
| Facility | | $1,174.90 | $1,258.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $186.21 / $208.93
| Professional | | $102.33 | $186.21 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $117.49 / $194.98 / $223.87
| Professional | 50 | $117.49 | $194.98 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $95.50 / $169.82
| Professional | | $47.86 | $95.50 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.99 / $85.11 / $199.53
| Professional | | $23.99 | $85.11 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $131.83 / $208.93
| Professional | | $72.44 | $131.83 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $741.31 / $891.25
| Facility | | $416.87 | $741.31 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $117.49 / $128.82
| Professional | | $87.10 | $117.49 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $1,584.89 / $8,317.64
| Facility | | $263.03 | $1,584.89 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $107.15 / $269.15
| Professional | | $45.71 | $107.15 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $91.20 / $91.20
| Professional | | $91.20 | $91.20 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $74.13 / $120.23
| Facility | | $47.86 | $74.13 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $74.13 / $309.03
| Professional | | $32.36 | $74.13 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $616.60 / $3,890.45
| Facility | | $223.87 | $616.60 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $89.13 / $169.82
| Professional | | $45.71 | $89.13 | $169.82 |