- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $2,884.03 / $7,585.78
| Facility | | $77.62 | $2,884.03 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $107.15 / $275.42
| Professional | | $46.77 | $107.15 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $120.23 / $288.40
| Professional | | $95.50 | $120.23 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $1,258.93 / $4,073.80
| Facility | | $69.18 | $1,258.93 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $69.18 / $158.49
| Professional | | $69.18 | $69.18 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $83.18 / $53,703.18
| Facility | | $34.67 | $83.18 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $154.88 / $407.38
| Professional | | $57.54 | $154.88 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $58.88 / $158.49
| Facility | | $44.67 | $58.88 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $144.54 / $208.93
| Professional | | $109.65 | $144.54 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $120.23 / $269.15
| Professional | | $95.50 | $120.23 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $50,118.72 / $75,857.76
| Facility | | $52.48 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $158.49 / $281.84
| Professional | | $131.83 | $158.49 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,311.31 / $6,165.95
| Facility | | $1,513.56 | $3,311.31 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $104.71 / $234.42
| Professional | | $46.77 | $104.71 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $51.29 / $154.88
| Facility | | $38.90 | $51.29 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $117.49 / $213.80
| Professional | | $87.10 | $117.49 | $213.80 |