- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $104.71 / $10,964.78
| Facility | | $44.67 | $104.71 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $50.12 / $8,128.31
| Professional | | $44.67 | $50.12 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $104.71 / $138.04
| Facility | | $38.90 | $104.71 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $45.71 / $56.23
| Professional | | $41.69 | $45.71 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $91.20
| Facility | | $45.71 | $45.71 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $45.71
| Facility | | $45.71 | $45.71 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $45.71
| Professional | | $45.71 | $45.71 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $83.18 / $8,511.38
| Facility | | $45.71 | $83.18 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $41.69 / $75.86
| Professional | | $41.69 | $41.69 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $3,019.95 / $10,471.29
| Facility | | $758.58 | $3,019.95 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $104.71 / $138.04
| Facility | | $38.90 | $104.71 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $45.71 / $56.23
| Professional | | $41.69 | $45.71 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $53.70 / $398.11
| Facility | | $20.89 | $53.70 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $45.71 / $87.10
| Facility | | $39.81 | $45.71 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $63.10
| Professional | | $45.71 | $45.71 | $63.10 |