- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.09 / $9,406.85 / $42,871.27
| Facility | | $31.09 | $9,406.85 | $42,871.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.08 / $31.39 / $46.17
| Professional | | $31.08 | $31.39 | $46.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.98 / $32.54 / $73.36
| Facility | | $19.98 | $32.54 | $73.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.98 / $19.98 / $19.98
| Professional | | $19.98 | $19.98 | $19.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.98 / $19.98 / $39.32
| Facility | | $19.98 | $19.98 | $39.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.64 / $17.64 / $19.98
| Facility | | $17.64 | $17.64 | $19.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.98 / $19.98 / $19.98
| Professional | | $19.98 | $19.98 | $19.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.55 / $205.00 / $238.00
| Professional | | $11.55 | $205.00 | $238.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,121.96 / $6,507.55 / $9,711.04
| Facility | | $2,121.96 | $6,507.55 | $9,711.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.09 / $40.09 / $101.77
| Professional | | $40.09 | $40.09 | $101.77 |