- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $2,884.03 / $7,762.47
| Facility | | $134.90 | $2,884.03 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $257.04 / $446.68
| Professional | | $91.20 | $257.04 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,888.44 / $12,302.69
| Facility | | $3,388.44 | $5,888.44 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $251.19 / $724.44
| Professional | | $190.55 | $251.19 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $1,258.93 / $16,595.87
| Facility | | $125.89 | $1,258.93 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $125.89 / $407.38
| Professional | | $125.89 | $125.89 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $151.36 / $50,118.72
| Facility | | $34.67 | $151.36 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $302.00 / $912.01
| Professional | | $97.72 | $302.00 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $141.25 / $323.59
| Facility | | $85.11 | $141.25 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $371.54 / $501.19
| Professional | | $288.40 | $371.54 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $316.23 / $501.19
| Professional | | $190.55 | $316.23 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $50,118.72 / $75,857.76
| Facility | | $3,235.94 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $389.05 / $436.52
| Professional | | $309.03 | $389.05 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,754.23 / $4,897.79
| Facility | | $1,318.26 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $251.19 / $575.44
| Professional | | $89.13 | $251.19 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $109.65 / $151.36
| Facility | | $70.79 | $109.65 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $239.88 / $457.09
| Professional | | $109.65 | $239.88 | $457.09 |