- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.03 / $2,691.53 / $5,623.41
| Facility | | $6.03 | $2,691.53 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $19.05 / $54.95
| Professional | | $6.03 | $19.05 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $208.93 / $2,818.38
| Facility | | $51.29 | $208.93 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $20.42 / $67.61
| Professional | | $7.76 | $20.42 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $8.32 / $19.50
| Facility | | $8.32 | $8.32 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $11.48 / $40.74
| Professional | | $7.94 | $11.48 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.38 / $21.38 / $21.38
| Professional | | $21.38 | $21.38 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $56.23 / $8,511.38
| Facility | | $8.13 | $56.23 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $33.11 / $46.77
| Professional | | $26.92 | $33.11 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $24.55 / $61.66
| Professional | | $8.13 | $24.55 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $208.93 / $2,818.38
| Facility | | $51.29 | $208.93 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $20.42 / $67.61
| Professional | | $7.76 | $20.42 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $74.13
| Professional | | $22.91 | $22.91 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $1,819.70 / $2,818.38
| Facility | | $194.98 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $19.50 / $54.95
| Professional | | $8.71 | $19.50 | $54.95 |