- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $2,818.38 / $9,120.11
| Facility | | $83.18 | $2,818.38 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.70 / $91.20 / $323.59
| Professional | | $53.70 | $91.20 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $85.11 / $223.87
| Professional | | $64.57 | $85.11 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $81.28 / $81.28
| Facility | | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $81.28 / $128.82
| Professional | | $81.28 | $81.28 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $97.72 / $50,118.72
| Facility | | $34.67 | $97.72 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $134.90 / $323.59
| Professional | | $67.61 | $134.90 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $131.83 / $218.78
| Facility | | $58.88 | $131.83 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $134.90 / $190.55
| Professional | | $109.65 | $134.90 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $123.03 / $194.98
| Professional | | $70.79 | $123.03 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $134.90 / $398.11
| Professional | | $109.65 | $134.90 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $2,754.23 / $4,897.79
| Facility | | $870.96 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $102.33 / $213.80
| Professional | | $61.66 | $102.33 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $66.07 / $213.80
| Facility | | $46.77 | $66.07 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $109.65 / $194.98
| Professional | | $70.79 | $109.65 | $194.98 |