- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $138.04 / $138.04
| Facility | | $120.23 | $138.04 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $28.18 / $151.36
| Professional | | $25.12 | $28.18 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $22.39 / $36.31
| Professional | | $19.05 | $22.39 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $38.02 / $38.02
| Facility | | $38.02 | $38.02 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $38.02 / $38.02
| Professional | | $38.02 | $38.02 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $50,118.72
| Facility | | $45.71 | $45.71 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $44.67 / $102.33
| Professional | | $28.84 | $44.67 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $38.02 / $89.13
| Facility | | $21.88 | $38.02 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $44.67 / $64.57
| Professional | | $36.31 | $44.67 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $29.51 / $29.51
| Facility | | $29.51 | $29.51 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $39.81 / $66.07
| Professional | | $25.12 | $39.81 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $50,118.72 / $75,857.76
| Facility | | $91.20 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.44 / $31.62 / $66.07
| Professional | | $23.44 | $31.62 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.12 / $28.18 / $44.67
| Facility | | $25.12 | $28.18 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $39.81 / $72.44
| Professional | | $25.12 | $39.81 | $72.44 |