- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $2,089.30 / $3,801.89
| Facility | | $123.03 | $2,089.30 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $154.88 / $446.68
| Professional | | $120.23 | $154.88 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $1,071.52 / $19,498.45
| Facility | | $338.84 | $1,071.52 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $213.80 / $524.81
| Professional | | $134.90 | $213.80 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $165.96 / $380.19
| Facility | | $165.96 | $165.96 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $263.03 / $501.19
| Professional | | $151.36 | $263.03 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $380.19 / $7,079.46
| Facility | | $138.04 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $251.19 / $363.08
| Professional | | $194.98 | $251.19 | $363.08 |
- 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
- $162.18 / $263.03 / $478.63
| Professional | | $162.18 | $263.03 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $407.38 / $416.87
| Facility | | $407.38 | $407.38 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,071.52 / $19,498.45
| Facility | | $346.74 | $1,071.52 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $218.78 / $524.81
| Professional | | $134.90 | $218.78 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,819.70 / $2,818.38
| Facility | | $575.44 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $223.87 / $467.74
| Professional | | $144.54 | $223.87 | $467.74 |