- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $17,782.79
| Facility | | $32.36 | $32.36 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $204.17 / $389.05
| Professional | | $34.67 | $204.17 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $263.03 / $1,445.44
| Professional | | $112.20 | $263.03 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $77.62 / $77.62
| Facility | | $77.62 | $77.62 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $218.78 / $1,230.27
| Professional | | $218.78 | $218.78 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $69.18 / $389.05
| Facility | | $33.88 | $69.18 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $338.84 / $630.96
| Professional | | $295.12 | $338.84 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $323.59 / $1,737.80
| Facility | | $37.15 | $323.59 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $562.34 / $1,230.27
| Professional | | $354.81 | $562.34 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $58.88 / $70.79
| Professional | | $33.11 | $58.88 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $109.65 / $691.83
| Professional | | $60.26 | $109.65 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $117.49 / $1,047.13
| Facility | | $117.49 | $117.49 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $1,047.13 / $1,047.13
| Professional | | $186.21 | $1,047.13 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,584.89 / $1,949.84
| Facility | | $1,023.29 | $1,584.89 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $467.74 / $1,288.25
| Professional | | $93.33 | $467.74 | $1,288.25 |