- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $2,818.38 / $5,623.41
| Facility | | $38.02 | $2,818.38 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $123.03 / $501.19
| Professional | | $45.71 | $123.03 | $501.19 |
- 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
- $52.48 / $117.49 / $354.81
| Professional | | $52.48 | $117.49 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $54.95 / $128.82
| Facility | | $54.95 | $54.95 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $125.89 / $316.23
| Professional | | $54.95 | $125.89 | $316.23 |
- 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
- $53.70 / $123.03 / $302.00
| Professional | | $53.70 | $123.03 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.98 / $85.11 / $7,079.46
| Facility | | $48.98 | $85.11 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $165.96 / $234.42
| Professional | | $125.89 | $165.96 | $234.42 |
- 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
- $48.98 / $120.23 / $302.00
| Professional | | $48.98 | $120.23 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $169.82 / $229.09
| Professional | | $147.91 | $169.82 | $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
- $52.48 / $117.49 / $363.08
| Professional | | $52.48 | $117.49 | $363.08 |
- 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
- $53.70 / $112.20 / $269.15
| Professional | | $53.70 | $112.20 | $269.15 |