- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $1,071.52 / $3,235.94
| Facility | | $89.13 | $1,071.52 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $95.50 / $426.58
| Professional | | $37.15 | $95.50 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,288.25 / $3,801.89
| Facility | | $56.23 | $1,288.25 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $112.20 / $316.23
| Professional | | $44.67 | $112.20 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $47.86 / $112.20
| Facility | | $47.86 | $47.86 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $117.49 / $269.15
| Professional | | $70.79 | $117.49 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $138.04 / $338.84
| Professional | | $66.07 | $138.04 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $177.83 / $7,079.46
| Facility | | $46.77 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $144.54 / $269.15
| Professional | | $114.82 | $144.54 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,511.89 / $7,079.46
| Facility | | $1,096.48 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $104.71 / $251.19
| Professional | | $43.65 | $104.71 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $630.96 / $1,318.26
| Facility | | $147.91 | $630.96 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $218.78 / $218.78
| Professional | | $218.78 | $218.78 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,348.96 / $3,801.89
| Facility | | $56.23 | $1,348.96 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $109.65 / $302.00
| Professional | | $44.67 | $109.65 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,344.23 / $6,165.95
| Facility | | $954.99 | $2,344.23 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $117.49 / $257.04
| Professional | | $50.12 | $117.49 | $257.04 |