- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $3,090.30 / $5,128.61
| Facility | | $194.98 | $3,090.30 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $218.78 / $512.86
| Professional | | $151.36 | $218.78 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $5,623.41 / $45,708.82
| Facility | | $389.05 | $5,623.41 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $281.84 / $707.95
| Professional | | $173.78 | $281.84 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $199.53 / $457.09
| Facility | | $199.53 | $199.53 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $354.81 / $645.65
| Professional | | $199.53 | $354.81 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $309.03 / $562.34
| Professional | | $177.83 | $309.03 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $575.44 / $7,079.46
| Facility | | $165.96 | $575.44 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $354.81 / $436.52
| Professional | | $288.40 | $354.81 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $331.13 / $645.65
| Professional | | $194.98 | $331.13 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $89.13 / $89.13
| Professional | | $89.13 | $89.13 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $5,623.41 / $45,708.82
| Facility | | $389.05 | $5,623.41 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $281.84 / $707.95
| Professional | | $173.78 | $281.84 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $10,715.19
| Facility | | $2,041.74 | $5,248.07 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $302.00 / $630.96
| Professional | | $177.83 | $302.00 | $630.96 |