- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $446.68 / $3,388.44
| Facility | | $91.20 | $446.68 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $125.89 / $426.58
| Professional | | $51.29 | $125.89 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $562.34 / $3,890.45
| Facility | | $56.23 | $562.34 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $138.04 / $338.84
| Professional | | $60.26 | $138.04 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $64.57 / $151.36
| Facility | | $64.57 | $64.57 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $117.49 / $194.98
| Professional | | $61.66 | $117.49 | $194.98 |
- 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
- $72.44 / $144.54 / $295.12
| Professional | | $72.44 | $144.54 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $380.19 / $7,079.46
| Facility | | $66.07 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $194.98 / $288.40
| Professional | | $154.88 | $194.98 | $288.40 |
- 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
- $67.61 / $147.91 / $371.54
| Professional | | $67.61 | $147.91 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $302.00 / $588.84
| Facility | | $120.23 | $302.00 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $562.34 / $3,890.45
| Facility | | $56.23 | $562.34 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $134.90 / $346.74
| Professional | | $60.26 | $134.90 | $346.74 |
- 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
- $72.44 / $147.91 / $323.59
| Professional | | $72.44 | $147.91 | $323.59 |