- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $5,011.87 / $41,686.94
| Facility | | $38.02 | $5,011.87 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $33.88 / $12,589.25
| Professional | | $33.11 | $33.88 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.62 / $45.71 / $48.98
| Facility | | $31.62 | $45.71 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $33.88 / $34.67
| Professional | | $33.88 | $33.88 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $33.88 / $44.67
| Professional | | $29.51 | $33.88 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $56.23 / $114.82
| Facility | | $47.86 | $56.23 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $38.90 / $46.77
| Professional | | $36.31 | $38.90 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $34.67 / $34.67
| Professional | | $28.84 | $34.67 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $33.11 / $40.74
| Professional | | $29.51 | $33.11 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $33.88 / $33.88
| Professional | | $33.88 | $33.88 | $33.88 |