- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $660.69 / $5,128.61
| Facility | | $57.54 | $660.69 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $95.50 / $346.74
| Professional | | $56.23 | $95.50 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $501.19 / $2,818.38
| Facility | | $56.23 | $501.19 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $114.82 / $269.15
| Professional | | $60.26 | $114.82 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $64.57 / $147.91
| Facility | | $64.57 | $64.57 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $162.18 / $295.12
| Professional | | $85.11 | $162.18 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $134.90 / $263.03
| Professional | | $77.62 | $134.90 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $177.83 / $7,079.46
| Facility | | $56.23 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $104.71 / $162.18
| Professional | | $57.54 | $104.71 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $112.20 / $239.88
| Professional | | $60.26 | $112.20 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $446.68
| Facility | | $229.09 | $229.09 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $562.34 / $2,818.38
| Facility | | $56.23 | $562.34 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $112.20 / $263.03
| Professional | | $60.26 | $112.20 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $120.23 / $239.88
| Professional | | $72.44 | $120.23 | $239.88 |