- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $389.05 / $501.19
| Facility | | $30.20 | $389.05 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $60.26 / $181.97
| Professional | | $30.20 | $60.26 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $575.44 / $2,818.38
| Facility | | $56.23 | $575.44 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $74.13 / $194.98
| Professional | | $35.48 | $74.13 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $38.02 / $89.13
| Facility | | $38.02 | $38.02 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $81.28 / $173.78
| Professional | | $38.02 | $81.28 | $173.78 |
- 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
- $41.69 / $77.62 / $151.36
| Professional | | $41.69 | $77.62 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $83.18 / $7,079.46
| Facility | | $36.31 | $83.18 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $100.00 / $134.90
| Professional | | $81.28 | $100.00 | $134.90 |
- 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
- $36.31 / $79.43 / $177.83
| Professional | | $36.31 | $79.43 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $316.23 / $354.81
| Facility | | $316.23 | $316.23 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $63.10 / $63.10
| Professional | | $63.10 | $63.10 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $575.44 / $2,818.38
| Facility | | $56.23 | $575.44 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $74.13 / $194.98
| Professional | | $35.48 | $74.13 | $194.98 |
- 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
- $37.15 / $75.86 / $165.96
| Professional | | $37.15 | $75.86 | $165.96 |