- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.68 / $538.20 / $4,806.64
| Facility | | $133.68 | $538.20 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.25 / $98.22 / $303.87
| Professional | | $69.25 | $98.22 | $303.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.90 / $335.30 / $2,733.00
| Facility | | $76.90 | $335.30 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.41 / $152.31 / $497.04
| Professional | | $73.41 | $152.31 | $497.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.15 / $101.71 / $181.57
| Facility | | $79.15 | $101.71 | $181.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.41 / $164.37 / $301.56
| Professional | | $107.41 | $164.37 | $301.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.68 / $144.57 / $242.13
| Professional | | $88.68 | $144.57 | $242.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.54 / $168.26 / $6,679.00
| Facility | | $80.54 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.41 / $128.88 / $176.76
| Professional | | $106.41 | $128.88 | $176.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.33 / $184.80 / $276.58
| Professional | | $87.33 | $184.80 | $276.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.64 / $1,181.61 / $3,721.98
| Facility | | $884.64 | $1,181.61 | $3,721.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.24 / $165.86 / $1,667.70
| Professional | | $147.24 | $165.86 | $1,667.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.51 / $180.95 / $669.04
| Professional | | $102.51 | $180.95 | $669.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.42 / $154.55 / $292.12
| Professional | | $100.42 | $154.55 | $292.12 |