- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $120.23 / $4,073.80
| Professional | | $77.62 | $120.23 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $81.28 / $147.91
| Professional | | $74.13 | $81.28 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $251.19 / $436.52
| Facility | | $181.97 | $251.19 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $120.23 / $181.97
| Professional | | $77.62 | $120.23 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $138.04 / $138.04
| Facility | | $138.04 | $138.04 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $104.71 / $208.93
| Professional | | $75.86 | $104.71 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $109.65 / $114.82
| Professional | | $109.65 | $109.65 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $107.15 / $186.21
| Facility | | $81.28 | $107.15 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Professional | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $83.18 / $128.82
| Professional | | $66.07 | $83.18 | $128.82 |