- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $588.84 / $2,884.03
| Facility | | $57.54 | $588.84 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $48.98 / $66.07
| Professional | | $40.74 | $48.98 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.70 / $54.95 / $54.95
| Professional | | $53.70 | $54.95 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $95.50 / $95.50
| Facility | | $95.50 | $95.50 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Professional | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $60.26
| Professional | | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $169.82 / $1,698.24
| Facility | | $57.54 | $169.82 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $794.33 / $4,786.30
| Facility | | $169.82 | $794.33 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $48.98 / $66.07
| Professional | | $41.69 | $48.98 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.60 / $0.60 / $0.60
| Professional | | $0.60 | $0.60 | $0.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $93.33 / $93.33
| Facility | | $93.33 | $93.33 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $93.33 / $93.33
| Professional | | $93.33 | $93.33 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $446.68 / $549.54
| Facility | | $229.09 | $446.68 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $66.07 / $120.23
| Professional | | $48.98 | $66.07 | $120.23 |