- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $7,585.78 / $13,489.63
| Facility | | $29.51 | $7,585.78 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $22.91 / $95.50
| Professional | | $7.08 | $22.91 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.39 / $22.39 / $22.39
| Professional | | $22.39 | $22.39 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $309.03 / $630.96
| Facility | | $245.47 | $309.03 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $18.62 / $45.71
| Professional | | $8.71 | $18.62 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $27.54 / $53.70
| Professional | | $11.75 | $27.54 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $26.30 / $1,230.27
| Facility | | $9.33 | $26.30 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $47.86 / $147.91
| Professional | | $26.92 | $47.86 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $34.67 / $56.23
| Professional | | $10.72 | $34.67 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $20.42 / $53.70
| Professional | | $16.60 | $20.42 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $1,230.27 / $4,570.88
| Facility | | $75.86 | $1,230.27 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $21.88 / $54.95
| Professional | | $10.00 | $21.88 | $54.95 |