- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.98 / $2,818.38 / $5,623.41
| Facility | | $48.98 | $2,818.38 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $128.82 / $407.38
| Professional | | $57.54 | $128.82 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $562.34 / $2,818.38
| Facility | | $56.23 | $562.34 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $141.25 / $407.38
| Professional | | $66.07 | $141.25 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $70.79 / $165.96
| Facility | | $70.79 | $70.79 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $158.49 / $354.81
| Professional | | $70.79 | $158.49 | $354.81 |
- 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
- $67.61 / $147.91 / $338.84
| Professional | | $67.61 | $147.91 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $109.65 / $7,079.46
| Facility | | $56.23 | $109.65 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $186.21 / $263.03
| Professional | | $141.25 | $186.21 | $263.03 |
- 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
- $61.66 / $138.04 / $338.84
| Professional | | $61.66 | $138.04 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $190.55 / $263.03
| Professional | | $165.96 | $190.55 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $562.34 / $2,818.38
| Facility | | $56.23 | $562.34 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $144.54 / $416.87
| Professional | | $66.07 | $144.54 | $416.87 |
- 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
- $67.61 / $134.90 / $309.03
| Professional | | $67.61 | $134.90 | $309.03 |