- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $2,238.72 / $3,801.89
| Facility | | $131.83 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $131.83 / $316.23
| Professional | | $61.66 | $131.83 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $4,677.35
| Facility | | $56.23 | $1,258.93 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $173.78 / $1,174.90
| Professional | | $70.79 | $173.78 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $75.86 / $177.83
| Facility | | $75.86 | $75.86 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $724.44 / $724.44
| Professional | | $707.95 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $275.42 / $741.31
| Facility | | $199.53 | $275.42 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $173.78 / $380.19
| Professional | | $77.62 | $173.78 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $177.83 / $7,079.46
| Facility | | $63.10 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $275.42 / $380.19
| Professional | | $199.53 | $275.42 | $380.19 |
- 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
- $74.13 / $186.21 / $467.74
| Professional | | $74.13 | $186.21 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $4,677.35
| Facility | | $56.23 | $1,258.93 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $173.78 / $1,174.90
| Professional | | $70.79 | $173.78 | $1,174.90 |
- 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
- $72.44 / $162.18 / $426.58
| Professional | | $72.44 | $162.18 | $426.58 |