- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $2,818.38 / $5,623.41
| Facility | | $66.07 | $2,818.38 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $112.20 / $354.81
| Professional | | $64.57 | $112.20 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,288.25 / $2,818.38
| Facility | | $56.23 | $1,288.25 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $128.82 / $831.76
| Professional | | $64.57 | $128.82 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $141.25
| Facility | | $60.26 | $60.26 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $125.89 / $288.40
| Professional | | $60.26 | $125.89 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $177.83 / $7,079.46
| Facility | | $51.29 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $158.49 / $223.87
| Professional | | $120.23 | $158.49 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $117.49 / $288.40
| Professional | | $51.29 | $117.49 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $186.21 / $204.17
| Professional | | $165.96 | $186.21 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,288.25 / $2,818.38
| Facility | | $56.23 | $1,288.25 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $128.82 / $831.76
| Professional | | $64.57 | $128.82 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $117.49 / $257.04
| Professional | | $60.26 | $117.49 | $257.04 |