- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $1,000.00 / $7,244.36
| Facility | | $61.66 | $1,000.00 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $58.88 / $213.80
| Professional | | $14.13 | $58.88 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $54.95 / $117.49
| Professional | | $11.75 | $54.95 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,230.27 / $57,543.99
| Facility | | $1,174.90 | $1,230.27 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $85.11 / $117.49
| Professional | | $67.61 | $85.11 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $331.13
| Facility | | $331.13 | $331.13 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $47.86 / $87.10
| Professional | | $15.14 | $47.86 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $51.29 / $120.23
| Professional | | $19.05 | $51.29 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $72.44 / $114.82
| Professional | | $29.51 | $72.44 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $354.81 / $912.01
| Facility | | $181.97 | $354.81 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $1,023.29 / $6,165.95
| Facility | | $61.66 | $1,023.29 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $48.98 / $162.18
| Professional | | $15.14 | $48.98 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.54 / $27.54 / $27.54
| Professional | | $27.54 | $27.54 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.49 / $34.67 / $75.86
| Facility | | $15.49 | $34.67 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $54.95 / $75.86
| Professional | | $15.14 | $54.95 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $616.60 / $3,890.45
| Facility | | $223.87 | $616.60 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $37.15 / $89.13
| Professional | | $14.79 | $37.15 | $89.13 |