- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $1,905.46 / $18,620.87
| Facility | | $107.15 | $1,905.46 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $234.42 / $512.86
| Professional | | $109.65 | $234.42 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $3,090.30 / $5,754.40
| Facility | | $2,238.72 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $239.88 / $616.60
| Professional | | $144.54 | $239.88 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $794.33 / $1,258.93
| Facility | | $676.08 | $794.33 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $457.09 / $1,047.13
| Professional | | $147.91 | $457.09 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $251.19 / $3,162.28
| Facility | | $114.82 | $251.19 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $398.11 / $741.31
| Professional | | $229.09 | $398.11 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $275.42 / $3,311.31
| Facility | | $123.03 | $275.42 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $537.03 / $1,862.09
| Professional | | $263.03 | $537.03 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $85.11
| Professional | | $32.36 | $33.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $380.19 / $794.33
| Professional | | $194.98 | $380.19 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $776.25 / $776.25
| Facility | | $302.00 | $776.25 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $537.03 / $1,778.28
| Professional | | $186.21 | $537.03 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $831.76 / $1,479.11
| Professional | | $436.52 | $831.76 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,818.38 / $4,677.35
| Facility | | $2,238.72 | $2,818.38 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $331.13 / $933.25
| Professional | | $147.91 | $331.13 | $933.25 |