- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $1,659.59 / $5,370.32
| Facility | | $91.20 | $1,659.59 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $165.96 / $478.63
| Professional | | $79.43 | $165.96 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $239.88 / $676.08
| Professional | | $112.20 | $239.88 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $537.03 / $870.96
| Facility | | $467.74 | $537.03 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $275.42 / $645.65
| Professional | | $102.33 | $275.42 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $169.82 / $2,238.72
| Facility | | $83.18 | $169.82 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $281.84 / $478.63
| Professional | | $147.91 | $281.84 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $177.83 / $3,630.78
| Facility | | $85.11 | $177.83 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $478.63 / $2,238.72
| Professional | | $173.78 | $478.63 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $114.82
| Professional | | $32.36 | $33.11 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $257.04 / $562.34
| Professional | | $128.82 | $257.04 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,981.07 / $3,981.07
| Facility | | $2,754.23 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $380.19 / $2,290.87
| Professional | | $102.33 | $380.19 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $467.74 / $891.25
| Professional | | $309.03 | $467.74 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,456.54
| Facility | | $2,884.03 | $3,801.89 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $186.21 / $489.78
| Professional | | $91.20 | $186.21 | $489.78 |