- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $87.10 / $3,162.28
| Facility | | $34.67 | $87.10 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $69.18 / $234.42
| Professional | | $38.02 | $69.18 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,584.89 / $6,165.95
| Facility | | $1,202.26 | $1,584.89 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $131.83 / $302.00
| Professional | | $69.18 | $131.83 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $245.47 / $398.11
| Facility | | $213.80 | $245.47 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $109.65 / $223.87
| Professional | | $47.86 | $109.65 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.69 / $123.03 / $3,981.07
| Facility | | $41.69 | $123.03 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $138.04 / $229.09
| Professional | | $77.62 | $138.04 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.66 / $125.89 / $1,737.80
| Facility | | $42.66 | $125.89 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $128.82 / $2,951.21
| Professional | | $70.79 | $128.82 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $128.82
| Professional | | $32.36 | $33.11 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $138.04 / $288.40
| Professional | | $75.86 | $138.04 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $107.15 / $275.42
| Facility | | $107.15 | $107.15 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $89.13 / $3,548.13
| Professional | | $47.86 | $89.13 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $181.97 / $338.84
| Professional | | $97.72 | $181.97 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,584.89 / $1,949.84
| Facility | | $1,023.29 | $1,584.89 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $95.50 / $245.47
| Professional | | $47.86 | $95.50 | $245.47 |