- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $3,630.78 / $8,317.64
| Facility | | $173.78 | $3,630.78 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $169.82 / $331.13
| Professional | | $141.25 | $169.82 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $6,760.83 / $7,413.10
| Facility | | $5,888.44 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $194.98 / $295.12
| Professional | | $144.54 | $194.98 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $165.96 / $3,311.31
| Professional | | $144.54 | $165.96 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,148.15 / $1,258.93
| Facility | | $489.78 | $1,148.15 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $208.93 / $346.74
| Professional | | $151.36 | $208.93 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $158.49 / $316.23
| Professional | | $131.83 | $158.49 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $354.81
| Professional | | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $194.98 / $309.03
| Facility | | $147.91 | $194.98 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $79.43
| Professional | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $204.17 / $741.31
| Facility | | $154.88 | $204.17 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $204.17 / $741.31
| Professional | | $154.88 | $204.17 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,884.03 / $5,754.40
| Facility | | $512.86 | $2,884.03 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $190.55 / $309.03
| Professional | | $128.82 | $190.55 | $309.03 |