- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $2,691.53 / $3,715.35
| Facility | | $138.04 | $2,691.53 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $93.33 / $251.19
| Professional | | $43.65 | $93.33 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $588.84 / $2,818.38
| Facility | | $56.23 | $588.84 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $107.15 / $281.84
| Professional | | $48.98 | $107.15 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $52.48 / $123.03
| Facility | | $52.48 | $52.48 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $107.15 / $251.19
| Professional | | $61.66 | $107.15 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $117.49 / $257.04
| Professional | | $57.54 | $117.49 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $380.19 / $7,079.46
| Facility | | $51.29 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $141.25 / $199.53
| Professional | | $112.20 | $141.25 | $199.53 |
- 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
- $47.86 / $109.65 / $251.19
| Professional | | $47.86 | $109.65 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $346.74 / $457.09
| Facility | | $338.84 | $346.74 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $588.84 / $2,818.38
| Facility | | $56.23 | $588.84 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $107.15 / $275.42
| Professional | | $48.98 | $107.15 | $275.42 |
- 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
- $52.48 / $117.49 / $257.04
| Professional | | $52.48 | $117.49 | $257.04 |