- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.49 / $2,123.73 / $7,920.26
| Facility | | $126.49 | $2,123.73 | $7,920.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.67 / $339.21 / $1,064.58
| Professional | | $60.67 | $339.21 | $1,064.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $866.68 / $866.68 / $1,937.44
| Facility | | $866.68 | $866.68 | $1,937.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.43 / $300.08 / $1,635.10
| Professional | | $101.43 | $300.08 | $1,635.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.00 / $179.24 / $1,428.87
| Professional | | $122.00 | $179.24 | $1,428.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.43 / $598.34 / $1,687.25
| Facility | | $98.43 | $598.34 | $1,687.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.64 / $905.19 / $1,441.72
| Professional | | $108.64 | $905.19 | $1,441.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.55 / $1,118.01 / $1,291.01
| Facility | | $134.55 | $1,118.01 | $1,291.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.43 / $836.63 / $1,687.25
| Facility | | $98.43 | $836.63 | $1,687.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.80 / $764.54 / $1,613.57
| Professional | | $124.80 | $764.54 | $1,613.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,215.19 / $2,820.85 / $3,393.44
| Facility | | $2,215.19 | $2,820.85 | $3,393.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.06 / $1,099.33 / $1,691.03
| Professional | | $126.06 | $1,099.33 | $1,691.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,472.00 / $4,880.00 / $7,233.00
| Facility | | $1,472.00 | $4,880.00 | $7,233.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $956.76 / $1,350.42 / $1,921.02
| Professional | | $956.76 | $1,350.42 | $1,921.02 |