- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $1,905.46 / $3,715.35
| Facility | | $151.36 | $1,905.46 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $61.66 / $234.42
| Professional | | $36.31 | $61.66 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $741.31 / $2,818.38
| Facility | | $56.23 | $741.31 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $54.95 / $54.95 / $54.95
| Facility | 53 | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $69.18 / $537.03
| Professional | | $33.88 | $69.18 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $83.18 / $109.65
| Professional | | $48.98 | $83.18 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $93.33 / $158.49
| Professional | | $54.95 | $93.33 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.98 / $85.11 / $7,079.46
| Facility | | $48.98 | $85.11 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $57.54 / $107.15
| Professional | | $47.86 | $57.54 | $107.15 |
- 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
- $41.69 / $61.66 / $112.20
| Professional | | $41.69 | $61.66 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $416.87
| Facility | | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $91.20 / $107.15
| Professional | | $91.20 | $91.20 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $954.99 / $2,818.38
| Facility | | $56.23 | $954.99 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $54.95 / $54.95 / $54.95
| Facility | 53 | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $69.18 / $537.03
| Professional | | $33.88 | $69.18 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $2,818.38
| Facility | | $630.96 | $1,862.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $77.62 / $131.83
| Professional | | $52.48 | $77.62 | $131.83 |