- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $131.83 / $467.74
| Facility | | $83.18 | $131.83 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $91.20 / $389.05
| Professional | | $83.18 | $91.20 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $33.11 / $64.57
| Professional | | $33.11 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $120.23 / $120.23
| Facility | | $72.44 | $120.23 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $120.23 / $120.23
| Professional | | $87.10 | $120.23 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.98 / $67.61 / $371.54
| Facility | | $48.98 | $67.61 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $131.83 / $426.58
| Professional | | $104.71 | $131.83 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $151.36 / $245.47
| Facility | | $45.71 | $151.36 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $24.55 / $66.07
| Professional | | $16.60 | $24.55 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $154.88 / $154.88
| Professional | | $18.20 | $154.88 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $117.49 / $151.36
| Facility | | $83.18 | $117.49 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.22 / $104.71 / $117.49
| Professional | | $16.22 | $104.71 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $16.22 / $27.54
| Facility | | $9.33 | $16.22 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $100.00 / $154.88
| Professional | | $9.33 | $100.00 | $154.88 |