- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $1,819.70 / $3,715.35
| Facility | | $114.82 | $1,819.70 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $151.36 / $446.68
| Professional | | $64.57 | $151.36 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,621.81 / $4,466.84
| Facility | | $56.23 | $1,621.81 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $186.21 / $489.78
| Professional | | $75.86 | $186.21 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $186.21
| Facility | | $79.43 | $79.43 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $190.55 / $338.84
| Professional | | $79.43 | $190.55 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $223.87 / $478.63
| Professional | | $107.15 | $223.87 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $123.03 / $7,079.46
| Facility | | $58.88 | $123.03 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $251.19 / $457.09
| Professional | | $199.53 | $251.19 | $457.09 |
- 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
- $69.18 / $173.78 / $436.52
| Professional | | $69.18 | $173.78 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $114.82 / $158.49
| Facility | | $109.65 | $114.82 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,621.81 / $4,466.84
| Facility | | $56.23 | $1,621.81 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $186.21 / $478.63
| Professional | | $75.86 | $186.21 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,511.89 / $6,165.95
| Facility | | $1,047.13 | $2,511.89 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $204.17 / $446.68
| Professional | | $91.20 | $204.17 | $446.68 |