- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $2,238.72 / $3,801.89
| Facility | | $194.98 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $181.97 / $398.11
| Professional | | $79.43 | $181.97 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $741.31 / $4,570.88
| Facility | | $56.23 | $741.31 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $199.53 / $588.84
| Professional | | $87.10 | $199.53 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $93.33 / $218.78
| Facility | | $93.33 | $93.33 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $234.42 / $436.52
| Professional | | $107.15 | $234.42 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $676.08 / $741.31
| Facility | | $239.88 | $676.08 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $229.09 / $489.78
| Professional | | $97.72 | $229.09 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $380.19 / $7,079.46
| Facility | | $81.28 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $302.00 / $426.58
| Professional | | $213.80 | $302.00 | $426.58 |
- 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
- $83.18 / $204.17 / $501.19
| Professional | | $83.18 | $204.17 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $741.31 / $4,570.88
| Facility | | $56.23 | $741.31 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $199.53 / $616.60
| Professional | | $87.10 | $199.53 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,691.53 / $8,511.38
| Facility | | $676.08 | $2,691.53 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $194.98 / $467.74
| Professional | | $87.10 | $194.98 | $467.74 |