- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $223.87 / $7,762.47
| Facility | | $75.86 | $223.87 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $79.43 / $162.18
| Professional | | $70.79 | $79.43 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,691.53 / $57,543.99
| Facility | | $2,630.27 | $2,691.53 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $107.15 / $154.88
| Professional | | $69.18 | $107.15 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $102.33 / $169.82
| Professional | | $75.86 | $102.33 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $102.33 / $112.20
| Professional | | $79.43 | $102.33 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $74.13 / $120.23
| Professional | | $66.07 | $74.13 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $23,988.33
| Facility | | $23,988.33 | $23,988.33 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $223.87 / $58,884.37
| Facility | | $75.86 | $223.87 | $58,884.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $91.20 / $208.93
| Professional | | $72.44 | $91.20 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $154.88
| Facility | | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $169.82 / $194.98
| Professional | | $147.91 | $169.82 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $281.84 / $758.58
| Facility | | $74.13 | $281.84 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $75.86 / $758.58
| Professional | | $46.77 | $75.86 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $1,071.52 / $3,890.45
| Facility | | $223.87 | $1,071.52 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $93.33 / $158.49
| Professional | | $72.44 | $93.33 | $158.49 |