- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $3,090.30 / $7,762.47
| Facility | | $74.13 | $3,090.30 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $61.66 / $177.83
| Professional | | $45.71 | $61.66 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $47.86 / $125.89
| Professional | | $36.31 | $47.86 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $1,258.93 / $4,073.80
| Facility | | $77.62 | $1,258.93 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $77.62 / $77.62
| Professional | | $77.62 | $77.62 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $91.20 / $50,118.72
| Facility | | $91.20 | $91.20 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $93.33 / $229.09
| Professional | | $43.65 | $93.33 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $56.23 / $141.25
| Facility | | $34.67 | $56.23 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $63.10 / $89.13
| Professional | | $51.29 | $63.10 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $66.07 / $120.23
| Professional | | $42.66 | $66.07 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $50,118.72 / $75,857.76
| Facility | | $87.10 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $81.28 / $398.11
| Professional | | $67.61 | $81.28 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $2,754.23 / $4,897.79
| Facility | | $870.96 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $60.26 / $151.36
| Professional | | $41.69 | $60.26 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $52.48 / $162.18
| Facility | | $39.81 | $52.48 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $64.57 / $123.03
| Professional | | $40.74 | $64.57 | $123.03 |