- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $2,691.53 / $3,801.89
| Facility | | $223.87 | $2,691.53 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $218.78 / $575.44
| Professional | | $131.83 | $218.78 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,905.46 / $5,623.41
| Facility | | $56.23 | $1,905.46 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $263.03 / $1,548.82
| Professional | | $144.54 | $263.03 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $162.18 / $371.54
| Facility | | $162.18 | $162.18 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $234.42 / $457.09
| Professional | | $158.49 | $234.42 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $588.84 / $645.65
| Facility | | $263.03 | $588.84 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $275.42 / $549.54
| Professional | | $151.36 | $275.42 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $501.19 / $7,079.46
| Facility | | $128.82 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $338.84 / $489.78
| Professional | | $239.88 | $338.84 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $269.15 / $562.34
| Professional | | $147.91 | $269.15 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,905.46 / $5,623.41
| Facility | | $56.23 | $1,905.46 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $257.04 / $1,548.82
| Professional | | $144.54 | $257.04 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,548.13 / $8,511.38
| Facility | | $676.08 | $3,548.13 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $263.03 / $549.54
| Professional | | $144.54 | $263.03 | $549.54 |