- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $1,288.25 / $7,244.36
| Facility | | $85.11 | $1,288.25 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $89.13 / $239.88
| Professional | | $32.36 | $89.13 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $91.20 / $112.20
| Professional | | $75.86 | $91.20 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,258.93 / $57,543.99
| Facility | | $1,174.90 | $1,258.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $75.86 / $131.83
| Professional | | $64.57 | $75.86 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $81.28 / $147.91
| Professional | | $35.48 | $81.28 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $120.23 / $131.83
| Professional | | $93.33 | $120.23 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $100.00 / $162.18
| Professional | | $50.12 | $100.00 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $549.54 / $1,348.96
| Facility | | $239.88 | $549.54 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $1,288.25 / $6,606.93
| Facility | | $97.72 | $1,288.25 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $87.10 / $208.93
| Professional | | $33.88 | $87.10 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $144.54 / $162.18
| Facility | | $144.54 | $144.54 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $165.96 / $186.21
| Professional | | $117.49 | $165.96 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.69 / $74.13 / $114.82
| Facility | | $41.69 | $74.13 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $72.44 / $114.82
| Professional | | $19.05 | $72.44 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $676.08 / $3,890.45
| Facility | | $223.87 | $676.08 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $67.61 / $131.83
| Professional | | $31.62 | $67.61 | $131.83 |