- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $2,238.72 / $3,801.89
| Facility | | $229.09 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $199.53 / $371.54
| Professional | | $85.11 | $199.53 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $2,344.23 / $19,498.45
| Facility | | $218.78 | $2,344.23 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $223.87 / $1,479.11
| Professional | | $95.50 | $223.87 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $138.04 / $323.59
| Facility | | $138.04 | $138.04 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $724.44 / $724.44
| Professional | | $630.96 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $1,412.54
| Facility | | $446.68 | $478.63 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $229.09 / $478.63
| Professional | | $107.15 | $229.09 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $380.19 / $7,079.46
| Facility | | $87.10 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $354.81 / $501.19
| Professional | | $251.19 | $354.81 | $501.19 |
- 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
- $104.71 / $239.88 / $588.84
| Professional | | $104.71 | $239.88 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $2,344.23 / $19,498.45
| Facility | | $218.78 | $2,344.23 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $223.87 / $1,479.11
| Professional | | $95.50 | $223.87 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,019.95 / $8,511.38
| Facility | | $676.08 | $3,019.95 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $218.78 / $549.54
| Professional | | $102.33 | $218.78 | $549.54 |