- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $257.04 / $457.09
| Facility | | $77.62 | $257.04 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $52.48 / $134.90
| Professional | | $28.18 | $52.48 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,162.28 / $10,471.29
| Facility | | $2,137.96 | $3,162.28 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $54.95 / $83.18
| Professional | | $33.11 | $54.95 | $83.18 |
- 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
- $39.81 / $64.57 / $102.33
| Professional | | $39.81 | $64.57 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $60.26 / $93.33
| Professional | | $47.86 | $60.26 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $66.07 / $97.72
| Professional | | $58.88 | $66.07 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $3,467.37 / $6,760.83
| Facility | | $1,288.25 | $3,467.37 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $52.48 / $102.33
| Professional | | $28.18 | $52.48 | $102.33 |