- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $2,187.76 / $3,801.89
| Facility | | $50.12 | $2,187.76 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.99 / $69.18 / $218.78
| Professional | | $23.99 | $69.18 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $562.34 / $2,818.38
| Facility | | $56.23 | $562.34 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $72.44 / $257.04
| Professional | | $30.20 | $72.44 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.62 / $31.62 / $74.13
| Facility | | $31.62 | $31.62 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $45.71 / $151.36
| Professional | | $30.20 | $45.71 | $151.36 |
- 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
- $31.62 / $81.28 / $223.87
| Professional | | $31.62 | $81.28 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $83.18 / $7,079.46
| Facility | | $30.90 | $83.18 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $123.03 / $177.83
| Professional | | $95.50 | $123.03 | $177.83 |
- 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
- $30.90 / $91.20 / $229.09
| Professional | | $30.90 | $91.20 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $562.34 / $2,818.38
| Facility | | $56.23 | $562.34 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $74.13 / $269.15
| Professional | | $30.20 | $74.13 | $269.15 |
- 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
- $33.88 / $70.79 / $199.53
| Professional | | $33.88 | $70.79 | $199.53 |