- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.26 / $1,134.75 / $1,413.65
| Facility | | $43.26 | $1,134.75 | $1,413.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.88 / $44.00 / $55.38
| Professional | | $39.88 | $44.00 | $55.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.97 / $63.57 / $88.45
| Professional | | $38.97 | $63.57 | $88.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.66 / $62.06 / $100.80
| Professional | | $44.66 | $62.06 | $100.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.56 / $66.59 / $67.53
| Professional | | $50.56 | $66.59 | $67.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $260.93 / $923.43 / $1,717.27
| Facility | | $260.93 | $923.43 | $1,717.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.20 / $1,178.14 / $2,824.43
| Facility | | $70.20 | $1,178.14 | $2,824.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.88 / $44.47 / $78.77
| Professional | | $39.88 | $44.47 | $78.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.70 / $93.00 / $110.40
| Professional | | $76.70 | $93.00 | $110.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.84 / $64.77 / $103.67
| Professional | | $45.84 | $64.77 | $103.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.54 / $41.54 / $41.54
| Facility | | $41.54 | $41.54 | $41.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.54 / $41.54 / $41.54
| Professional | | $41.54 | $41.54 | $41.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $364.00 / $946.24 / $3,000.00
| Facility | | $364.00 | $946.24 | $3,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.81 / $56.34 / $92.53
| Professional | | $44.81 | $56.34 | $92.53 |