- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $1,862.09 / $7,079.46
| Facility | | $190.55 | $1,862.09 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $181.97 / $371.54
| Professional | | $120.23 | $181.97 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,570.40 / $2,951.21
| Facility | | $2,137.96 | $2,570.40 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $223.87 / $331.13
| Professional | | $151.36 | $223.87 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $1,737.80 / $2,754.23
| Professional | | $154.88 | $1,737.80 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $251.19 / $1,318.26
| Facility | | $251.19 | $251.19 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $199.53 / $338.84
| Professional | | $147.91 | $199.53 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $239.88 / $281.84
| Professional | | $181.97 | $239.88 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $263.03
| Professional | | $229.09 | $229.09 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $194.98 / $295.12
| Facility | | $138.04 | $194.98 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $380.19
| Professional | | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $194.98 / $3,311.31
| Facility | | $117.49 | $194.98 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $257.04 / $3,311.31
| Professional | | $169.82 | $257.04 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,137.96 / $3,981.07
| Facility | | $1,096.48 | $2,137.96 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $181.97 / $323.59
| Professional | | $120.23 | $181.97 | $323.59 |