- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.63 / $391.47 / $983.62
| Facility | | $224.63 | $391.47 | $983.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.65 / $165.17 / $1,585.12
| Professional | | $41.65 | $165.17 | $1,585.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.89 / $645.21 / $1,022.10
| Facility | | $169.89 | $645.21 | $1,022.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.76 / $235.28 / $1,139.64
| Professional | | $161.76 | $235.28 | $1,139.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.78 / $432.65 / $721.08
| Facility | | $116.78 | $432.65 | $721.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.29 / $185.34 / $246.34
| Professional | | $112.29 | $185.34 | $246.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.17 / $246.52 / $457.14
| Facility | | $165.17 | $246.52 | $457.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.54 / $103.80 / $1,232.59
| Professional | | $103.54 | $103.80 | $1,232.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.54 / $103.64 / $147.91
| Professional | | $103.54 | $103.64 | $147.91 |