- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.74 / $2,818.38 / $5,623.41
| Facility | | $40.74 | $2,818.38 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $72.44 / $186.21
| Professional | | $38.02 | $72.44 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $1,023.29 / $13,489.63
| Facility | | $97.72 | $1,023.29 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $87.10 / $223.87
| Professional | | $42.66 | $87.10 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $107.15
| Facility | | $45.71 | $45.71 | $107.15 |
- 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
- $56.23 / $107.15 / $239.88
| Professional | | $56.23 | $107.15 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $177.83 / $7,079.46
| Facility | | $46.77 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $91.20 / $134.90
| Professional | | $48.98 | $91.20 | $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
- $43.65 / $93.33 / $199.53
| Professional | | $43.65 | $93.33 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $1,071.52 / $13,489.63
| Facility | | $97.72 | $1,071.52 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $87.10 / $218.78
| Professional | | $42.66 | $87.10 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $1,819.70 / $2,818.38
| Facility | | $338.84 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $93.33 / $199.53
| Professional | | $45.71 | $93.33 | $199.53 |