- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.66 / $1,981.00 / $10,234.00
| Facility | | $60.66 | $1,981.00 | $10,234.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.08 / $57.80 / $93.84
| Professional | | $39.08 | $57.80 | $93.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.69 / $570.84 / $1,232.57
| Facility | | $272.69 | $570.84 | $1,232.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.06 / $55.69 / $86.00
| Professional | | $38.06 | $55.69 | $86.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.27 / $40.27 / $40.27
| Facility | | $40.27 | $40.27 | $40.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.04 / $47.61 / $62.20
| Facility | | $37.04 | $47.61 | $62.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.58 / $62.24 / $96.32
| Professional | | $42.58 | $62.24 | $96.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $715.03
| Facility | | $55.00 | $55.00 | $715.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $715.03 / $1,937.21 / $2,001.13
| Professional | | $715.03 | $1,937.21 | $2,001.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.88 / $60.67 / $100.09
| Facility | | $40.88 | $60.67 | $100.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.41 / $65.36 / $96.44
| Professional | | $43.41 | $65.36 | $96.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.86 / $52.63 / $66.48
| Professional | | $36.86 | $52.63 | $66.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.88 / $60.67 / $105.06
| Facility | | $40.88 | $60.67 | $105.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.43 / $63.85 / $102.16
| Professional | | $43.43 | $63.85 | $102.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $950.00 / $2,376.00
| Facility | | $157.00 | $950.00 | $2,376.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.63 / $60.58 / $88.08
| Professional | | $45.63 | $60.58 | $88.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.97 / $56.56 / $79.26
| Professional | | $49.97 | $56.56 | $79.26 |