- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $2,951.21 / $7,413.10
| Facility | | $147.91 | $2,951.21 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $138.04 / $446.68
| Professional | | $81.28 | $138.04 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $81.28 / $147.91
| Professional | | $41.69 | $81.28 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $257.04 / $302.00
| Professional | | $154.88 | $257.04 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $151.36 / $223.87
| Professional | | $91.20 | $151.36 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $245.47 / $269.15
| Professional | | $190.55 | $245.47 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $208.93 / $281.84
| Professional | | $138.04 | $208.93 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $3,890.45 / $6,606.93
| Facility | | $1,412.54 | $3,890.45 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $154.88 / $158.49
| Professional | | $144.54 | $154.88 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $2,570.40 / $7,244.36
| Facility | | $199.53 | $2,570.40 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $147.91 / $363.08
| Professional | | $83.18 | $147.91 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $173.78 / $173.78
| Professional | | $173.78 | $173.78 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.18 / $93.33 / $302.00
| Facility | | $28.18 | $93.33 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $151.36 / $302.00
| Professional | | $48.98 | $151.36 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,238.72 / $4,265.80
| Facility | | $912.01 | $2,238.72 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $147.91 / $245.47
| Professional | | $87.10 | $147.91 | $245.47 |