- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.83 / $2,249.84 / $7,394.03
| Facility | | $261.83 | $2,249.84 | $7,394.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.26 / $196.55 / $577.36
| Professional | | $85.26 | $196.55 | $577.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.61 / $325.92 / $1,033.58
| Professional | | $196.61 | $325.92 | $1,033.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.44 / $234.51 / $791.50
| Professional | | $98.44 | $234.51 | $791.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.31 / $356.85 / $367.04
| Professional | | $269.31 | $356.85 | $367.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $804.80 / $1,666.23 / $2,139.87
| Facility | | $804.80 | $1,666.23 | $2,139.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.00 / $2,070.00 / $7,394.03
| Facility | | $490.00 | $2,070.00 | $7,394.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.04 / $228.58 / $667.81
| Professional | | $86.04 | $228.58 | $667.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $576.20 / $1,284.70
| Professional | | $4.00 | $576.20 | $1,284.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.05 / $235.59 / $762.67
| Professional | | $99.05 | $235.59 | $762.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.41 / $86.15 / $487.13
| Facility | | $82.41 | $86.15 | $487.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.33 / $222.76 / $243.64
| Professional | | $83.33 | $222.76 | $243.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.00 / $1,305.00 / $3,742.00
| Facility | | $471.00 | $1,305.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.19 / $353.07 / $745.67
| Professional | | $199.19 | $353.07 | $745.67 |