- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $57.54 / $812.83
| Facility | | $20.89 | $57.54 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.89 / $28.84 / $57.54
| Professional | | $20.89 | $28.84 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $21.38 / $72.44
| Professional | | $16.60 | $21.38 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $41.69 / $41.69
| Facility | | $38.90 | $41.69 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $41.69 / $41.69
| Professional | | $41.69 | $41.69 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $83.18 / $53,703.18
| Facility | | $83.18 | $83.18 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $34.67 / $251.19
| Professional | | $34.67 | $34.67 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $85.11 / $199.53
| Facility | | $51.29 | $85.11 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $61.66 / $147.91
| Professional | | $45.71 | $61.66 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $35.48 / $41.69
| Professional | | $33.88 | $35.48 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,344.23 / $2,344.23
| Facility | | $2,344.23 | $2,344.23 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $32.36 / $51.29
| Professional | | $16.98 | $32.36 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $33.88 / $33.88
| Facility | | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $35.48 / $41.69
| Professional | | $33.88 | $35.48 | $41.69 |