- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $3,162.28 / $4,570.88
| Facility | | $38.90 | $3,162.28 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $38.02 / $69.18
| Professional | | $32.36 | $38.02 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $48.98 / $63.10
| Professional | | $30.20 | $48.98 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $75.86
| Professional | | $32.36 | $33.11 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $616.60 / $8,912.51
| Facility | | $524.81 | $616.60 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $54.95 / $64.57
| Professional | | $45.71 | $54.95 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $45.71 / $61.66
| Professional | | $33.88 | $45.71 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $48.98 / $75.86
| Professional | | $39.81 | $48.98 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,128.61 / $7,079.46
| Facility | | $1,995.26 | $5,128.61 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $39.81 / $58.88
| Professional | | $30.20 | $39.81 | $58.88 |