- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.21 / $305.52 / $1,080.08
| Facility | | $33.21 | $305.52 | $1,080.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.54 / $31.28 / $52.78
| Professional | | $23.54 | $31.28 | $52.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.51 / $94.60 / $150.29
| Facility | | $71.51 | $94.60 | $150.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.36 / $46.63 / $67.09
| Professional | | $33.36 | $46.63 | $67.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.52 / $180.22 / $351.64
| Facility | | $41.52 | $180.22 | $351.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.61 / $36.40 / $63.54
| Professional | | $24.61 | $36.40 | $63.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $41.22 / $63.64
| Facility | | $32.36 | $41.22 | $63.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.53 / $58.53 / $62.49
| Professional | | $58.53 | $58.53 | $62.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.13 / $51.26 / $69.61
| Professional | | $41.13 | $51.26 | $69.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.66 / $47.72 / $73.11
| Professional | | $27.66 | $47.72 | $73.11 |