- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $1,819.70 / $3,715.35
| Facility | | $131.83 | $1,819.70 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $138.04 / $660.69
| Professional | | $42.66 | $138.04 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $501.19 / $2,818.38
| Facility | | $56.23 | $501.19 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $141.25 / $489.78
| Professional | | $50.12 | $141.25 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $54.95 / $128.82
| Facility | | $54.95 | $54.95 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $109.65 / $416.87
| Professional | | $109.65 | $109.65 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $213.80 / $489.78
| Professional | | $75.86 | $213.80 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $87.10 / $8,511.38
| Facility | | $50.12 | $87.10 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $245.47 / $398.11
| Professional | | $194.98 | $245.47 | $398.11 |
- 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
- $50.12 / $169.82 / $416.87
| Professional | | $50.12 | $169.82 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $1,548.82 / $1,995.26
| Facility | | $338.84 | $1,548.82 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $501.19 / $2,818.38
| Facility | | $56.23 | $501.19 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $141.25 / $489.78
| Professional | | $50.12 | $141.25 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $2,818.38
| Facility | | $630.96 | $1,862.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $169.82 / $416.87
| Professional | | $58.88 | $169.82 | $416.87 |