- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.46 / $445.49 / $2,200.88
| Facility | | $98.46 | $445.49 | $2,200.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.09 / $91.60 / $201.44
| Professional | | $61.09 | $91.60 | $201.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.84 / $138.87 / $186.14
| Professional | | $97.84 | $138.87 | $186.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.76 / $114.76 / $114.76
| Facility | | $114.76 | $114.76 | $114.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.27 / $99.46 / $172.15
| Professional | | $67.27 | $99.46 | $172.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.52 / $158.04 / $203.00
| Professional | | $117.52 | $158.04 | $203.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.55 / $612.00 / $910.91
| Facility | | $300.55 | $612.00 | $910.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.32 / $108.42 / $225.17
| Professional | | $86.32 | $108.42 | $225.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.46 / $206.12 / $600.66
| Facility | | $98.46 | $206.12 | $600.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.06 / $99.37 / $210.68
| Professional | | $65.06 | $99.37 | $210.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.50 / $98.01 / $196.80
| Professional | | $92.50 | $98.01 | $196.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.76 / $114.76 / $114.76
| Facility | | $114.76 | $114.76 | $114.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.06 / $100.81 / $174.65
| Professional | | $68.06 | $100.81 | $174.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.86 / $65.37 / $93.51
| Facility | | $56.86 | $65.37 | $93.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.46 / $75.05 / $100.43
| Professional | | $63.46 | $75.05 | $100.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.34 / $112.58 / $185.60
| Professional | | $82.34 | $112.58 | $185.60 |