- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $2,570.40 / $7,079.46
| Facility | | $144.54 | $2,570.40 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $218.78 / $446.68
| Professional | | $79.43 | $218.78 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,570.40 / $2,951.21
| Facility | | $2,137.96 | $2,570.40 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $213.80 / $478.63
| Professional | | $89.13 | $213.80 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $95.50 / $1,737.80
| Professional | | $83.18 | $95.50 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $501.19 / $616.60
| Facility | | $338.84 | $501.19 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $208.93 / $446.68
| Professional | | $87.10 | $208.93 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $380.19 / $645.65
| Professional | | $316.23 | $380.19 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $338.84 / $354.81
| Professional | | $281.84 | $338.84 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $218.78 / $478.63
| Facility | | $87.10 | $218.78 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $104.71 / $549.54
| Professional | | $104.71 | $104.71 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $107.15 / $794.33
| Facility | | $83.18 | $107.15 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $309.03 / $1,174.90
| Professional | | $223.87 | $309.03 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,818.38 / $5,754.40
| Facility | | $512.86 | $2,818.38 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $177.83 / $407.38
| Professional | | $75.86 | $177.83 | $407.38 |