- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $2,818.38 / $5,623.41
| Facility | | $47.86 | $2,818.38 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $72.44 / $204.17
| Professional | | $41.69 | $72.44 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $707.95 / $2,818.38
| Facility | | $56.23 | $707.95 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $97.72 / $245.47
| Professional | | $51.29 | $97.72 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $54.95 / $125.89
| Facility | | $54.95 | $54.95 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $147.91 / $269.15
| Professional | | $93.33 | $147.91 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $112.20 / $234.42
| Professional | | $63.10 | $112.20 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $177.83 / $7,079.46
| Facility | | $50.12 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $95.50 / $144.54
| Professional | | $51.29 | $95.50 | $144.54 |
- 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
- $50.12 / $102.33 / $218.78
| Professional | | $50.12 | $102.33 | $218.78 |
- 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
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $97.72 / $239.88
| Professional | | $51.29 | $97.72 | $239.88 |
- 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
- $61.66 / $107.15 / $213.80
| Professional | | $61.66 | $107.15 | $213.80 |