- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $2,238.72 / $3,801.89
| Facility | | $245.47 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $218.78 / $489.78
| Professional | | $79.43 | $218.78 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $1,949.84 / $19,498.45
| Facility | | $204.17 | $1,949.84 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $275.42 / $1,995.26
| Professional | | $91.20 | $275.42 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $97.72 / $229.09
| Facility | | $97.72 | $97.72 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $346.74 / $758.58
| Professional | | $128.82 | $346.74 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $501.19 / $1,096.48
| Facility | | $446.68 | $501.19 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $234.42 / $616.60
| Professional | | $95.50 | $234.42 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $380.19 / $7,079.46
| Facility | | $83.18 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $478.63 / $676.08
| Professional | | $346.74 | $478.63 | $676.08 |
- 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
- $97.72 / $323.59 / $812.83
| Professional | | $97.72 | $323.59 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $1,949.84 / $19,498.45
| Facility | | $204.17 | $1,949.84 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $275.42 / $1,995.26
| Professional | | $91.20 | $275.42 | $1,995.26 |
- 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
- $91.20 / $239.88 / $741.31
| Professional | | $91.20 | $239.88 | $741.31 |