- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.65 / $6,918.31 / $17,782.79
| Facility | | $43.65 | $6,918.31 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $33.11 / $8,709.64
| Professional | | $30.20 | $33.11 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.54 / $32.36 / $5,011.87
| Facility | | $27.54 | $32.36 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $30.90 / $30.90
| Professional | | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.20
| Professional | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $52.48 / $52.48
| Professional | | $45.71 | $52.48 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.55 / $77.62 / $251.19
| Facility | | $24.55 | $77.62 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.48 / $6,606.93 / $17,378.01
| Facility | | $35.48 | $6,606.93 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $34.67 / $6,309.57
| Professional | | $30.20 | $34.67 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.95 / $33.88 / $56.23
| Facility | | $19.95 | $33.88 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $33.88 / $56.23
| Professional | | $19.95 | $33.88 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $42.66 / $64.57
| Professional | | $30.20 | $42.66 | $64.57 |