- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $208.93 / $9,120.11
| Facility | | $52.48 | $208.93 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $61.66 / $102.33
| Professional | | $39.81 | $61.66 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.51 / $51.29 / $67.61
| Professional | | $8.51 | $51.29 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $218.78 / $389.05
| Facility | | $97.72 | $218.78 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $64.57 / $100.00
| Professional | | $38.02 | $64.57 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $64.57 / $131.83
| Professional | | $43.65 | $64.57 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.66 / $64.57 / $120.23
| Facility | | $42.66 | $64.57 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $1,230.27 / $3,548.13
| Facility | | $354.81 | $1,230.27 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $54.95 / $87.10
| Professional | | $37.15 | $54.95 | $87.10 |