- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.62 / $308.19 / $7,984.74
| Facility | | $98.62 | $308.19 | $7,984.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.93 / $131.82 / $303.14
| Professional | | $72.93 | $131.82 | $303.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $249.58 / $567.02 / $1,107.58
| Facility | | $249.58 | $567.02 | $1,107.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.00 / $252.73 / $1,072.34
| Professional | | $112.00 | $252.73 | $1,072.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.50 / $174.03 / $352.23
| Professional | | $92.50 | $174.03 | $352.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.20 / $183.40 / $356.57
| Facility | | $103.20 | $183.40 | $356.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.91 / $184.80 / $356.57
| Professional | | $105.91 | $184.80 | $356.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.11 / $150.05 / $267.18
| Professional | | $27.11 | $150.05 | $267.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.63 / $242.54 / $268.67
| Facility | | $129.63 | $242.54 | $268.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.12 / $177.12 / $183.26
| Facility | | $177.12 | $177.12 | $183.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.40 / $186.65 / $330.90
| Professional | | $103.40 | $186.65 | $330.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $367.90 / $567.35 / $1,085.27
| Facility | | $367.90 | $567.35 | $1,085.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.33 / $180.64 / $320.80
| Professional | | $99.33 | $180.64 | $320.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.29 / $710.68 / $1,367.56
| Facility | | $531.29 | $710.68 | $1,367.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.66 / $201.10 / $370.66
| Professional | | $158.66 | $201.10 | $370.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.84 / $74.84 / $145.88
| Professional | | $74.84 | $74.84 | $145.88 |