- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $2,570.40 / $7,762.47
| Facility | | $223.87 | $2,570.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $331.13 / $1,348.96
| Professional | | $72.44 | $331.13 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $60.26 / $77.62
| Professional | | $42.66 | $60.26 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,691.53 / $57,543.99
| Facility | | $2,630.27 | $2,691.53 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $616.60 / $977.24
| Professional | | $338.84 | $616.60 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $186.21 / $676.08
| Professional | | $83.18 | $186.21 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $537.03 / $588.84
| Professional | | $416.87 | $537.03 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $478.63 / $741.31
| Professional | | $134.90 | $478.63 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,698.24 / $3,235.94
| Facility | | $1,071.52 | $1,698.24 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $2,187.76 / $7,244.36
| Facility | | $354.81 | $2,187.76 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $331.13 / $1,047.13
| Professional | | $74.13 | $331.13 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $602.56
| Professional | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $302.00 / $562.34
| Facility | | $83.18 | $302.00 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $251.19 / $416.87
| Professional | | $83.18 | $251.19 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,584.89 / $3,890.45
| Facility | | $501.19 | $1,584.89 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $218.78 / $707.95
| Professional | | $77.62 | $218.78 | $707.95 |