- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,145.78 / $7,838.38
| Facility | | $1,000.00 | $2,145.78 | $7,838.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.48 / $34.65 / $78.78
| Professional | | $31.48 | $34.65 | $78.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.75 / $649.37 / $1,128.32
| Facility | | $280.75 | $649.37 | $1,128.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.69 / $42.26 / $64.05
| Professional | | $33.69 | $42.26 | $64.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.11 / $52.62 / $65.45
| Professional | | $40.11 | $52.62 | $65.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.09 / $32.34 / $53.58
| Professional | | $10.09 | $32.34 | $53.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.40 / $81.13 / $103.27
| Facility | | $41.40 | $81.13 | $103.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.11 / $52.33 / $65.45
| Professional | | $40.11 | $52.33 | $65.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $775.00 / $1,327.00 / $1,327.00
| Facility | | $775.00 | $1,327.00 | $1,327.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.50 / $54.58 / $81.36
| Professional | | $40.50 | $54.58 | $81.36 |