- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,818.38 / $8,317.64
| Facility | | $724.44 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $173.78 / $676.08
| Professional | | $104.71 | $173.78 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,398.83 / $57,543.99
| Facility | | $2,344.23 | $2,398.83 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $354.81
| Professional | | $346.74 | $346.74 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $177.83 / $295.12
| Professional | | $109.65 | $177.83 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $154.88 / $338.84
| Professional | | $28.84 | $154.88 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $223.87 / $354.81
| Professional | | $138.04 | $223.87 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $3,235.94
| Facility | | $1,862.09 | $1,862.09 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $190.55 / $208.93
| Professional | | $190.55 | $190.55 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,398.83 / $8,317.64
| Facility | | $616.60 | $2,398.83 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $181.97 / $489.78
| Professional | | $104.71 | $181.97 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $169.82 / $169.82
| Professional | | $169.82 | $169.82 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $158.49 / $309.03
| Facility | | $102.33 | $158.49 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $194.98 / $346.74
| Professional | | $87.10 | $194.98 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,584.89 / $3,890.45
| Facility | | $467.74 | $1,584.89 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $169.82 / $295.12
| Professional | | $102.33 | $169.82 | $295.12 |