- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $2,454.71 / $7,762.47
| Facility | | $147.91 | $2,454.71 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $158.49 / $676.08
| Professional | | $112.20 | $158.49 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $199.53 / $288.40
| Professional | | $162.18 | $199.53 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $186.21 / $302.00
| Professional | | $141.25 | $186.21 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $257.04 / $288.40
| Professional | | $199.53 | $257.04 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $199.53 / $309.03
| Professional | | $147.91 | $199.53 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,137.96 / $4,365.16
| Facility | | $912.01 | $2,137.96 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $1,584.89 / $7,762.47
| Facility | | $154.88 | $1,584.89 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $186.21 / $446.68
| Professional | | $120.23 | $186.21 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $181.97 / $316.23
| Facility | | $181.97 | $181.97 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $281.84 / $338.84
| Professional | | $169.82 | $281.84 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $162.18 / $190.55
| Facility | | $138.04 | $162.18 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $158.49 / $309.03
| Professional | | $75.86 | $158.49 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,949.84 / $3,890.45
| Facility | | $501.19 | $1,949.84 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $169.82 / $281.84
| Professional | | $128.82 | $169.82 | $281.84 |