- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $5,495.41 / $10,232.93
| Facility | | $316.23 | $5,495.41 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $151.36 / $309.03
| Professional | | $74.13 | $151.36 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $3,630.78 / $8,511.38
| Facility | | $1,445.44 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $275.42 / $346.74
| Professional | | $138.04 | $275.42 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $208.93 / $426.58 / $524.81
| Professional | 50 | $208.93 | $426.58 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $154.88 / $309.03
| Professional | | $93.33 | $154.88 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $1,230.27 / $9,549.93
| Facility | | $134.90 | $1,230.27 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $154.88 / $354.81
| Professional | | $81.28 | $154.88 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $6,456.54 / $8,912.51
| Facility | | $4,570.88 | $6,456.54 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $147.91 / $288.40
| Professional | | $102.33 | $147.91 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $165.96 / $6,760.83
| Professional | | $147.91 | $165.96 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $6,165.95 / $7,762.47
| Facility | | $3,467.37 | $6,165.95 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $169.82 / $302.00
| Professional | | $85.11 | $169.82 | $302.00 |