- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $426.58 / $3,090.30
| Facility | | $79.43 | $426.58 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $173.78 / $407.38
| Professional | | $69.18 | $173.78 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $263.03 / $776.25
| Professional | | $97.72 | $263.03 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $660.69 / $1,071.52
| Facility | | $575.44 | $660.69 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $263.03 / $831.76
| Professional | | $91.20 | $263.03 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $199.53 / $3,090.30
| Facility | | $72.44 | $199.53 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $288.40 / $549.54
| Professional | | $131.83 | $288.40 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $204.17 / $3,548.13
| Facility | | $72.44 | $204.17 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $389.05 / $1,548.82
| Professional | | $194.98 | $389.05 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $93.33
| Professional | | $32.36 | $33.11 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $316.23 / $812.83
| Professional | | $128.82 | $316.23 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $1,949.84 / $2,884.03
| Facility | | $1,949.84 | $1,949.84 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $281.84 / $1,479.11
| Professional | | $87.10 | $281.84 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $398.11 / $1,071.52
| Professional | | $234.42 | $398.11 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,630.78 / $6,456.54
| Facility | | $2,884.03 | $3,630.78 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $208.93 / $524.81
| Professional | | $79.43 | $208.93 | $524.81 |