- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $912.01 / $7,244.36
| Facility | | $47.86 | $912.01 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $42.66 / $104.71
| Professional | | $32.36 | $42.66 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $40.74 / $46.77
| Professional | | $25.70 | $40.74 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $4,466.84 / $8,709.64
| Facility | | $501.19 | $4,466.84 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $38.90 / $141.25
| Professional | | $29.51 | $38.90 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $38.90 / $66.07
| Facility | | $30.90 | $38.90 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $70.79 / $154.88
| Facility | | $44.67 | $70.79 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $50.12 / $87.10
| Professional | | $36.31 | $50.12 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $2,137.96 / $5,754.40
| Facility | | $251.19 | $2,137.96 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $46.77 / $81.28
| Professional | | $32.36 | $46.77 | $81.28 |