- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $2,238.72 / $4,168.69
| Facility | | $144.54 | $2,238.72 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $194.98 / $660.69
| Professional | | $144.54 | $194.98 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,584.89 / $3,801.89
| Facility | | $56.23 | $1,584.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $245.47 / $524.81
| Professional | | $138.04 | $245.47 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $181.97 / $407.38
| Facility | | $181.97 | $181.97 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $316.23 / $489.78
| Professional | | $213.80 | $316.23 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $338.84 / $575.44
| Professional | | $208.93 | $338.84 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $302.00 / $8,511.38
| Facility | | $147.91 | $302.00 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $281.84 / $426.58
| Professional | | $223.87 | $281.84 | $426.58 |
- 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
- $177.83 / $288.40 / $501.19
| Professional | | $177.83 | $288.40 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $933.25 / $933.25
| Facility | | $776.25 | $933.25 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,584.89 / $3,801.89
| Facility | | $56.23 | $1,584.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $239.88 / $524.81
| Professional | | $138.04 | $239.88 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,089.30 / $6,165.95
| Facility | | $891.25 | $2,089.30 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $281.84 / $524.81
| Professional | | $186.21 | $281.84 | $524.81 |