- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $2,818.38 / $5,623.41
| Facility | | $69.18 | $2,818.38 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $83.18 / $204.17
| Professional | | $66.07 | $83.18 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $630.96 / $2,754.23
| Facility | | $56.23 | $630.96 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $95.50 / $239.88
| Professional | | $56.23 | $95.50 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $74.13 / $169.82
| Facility | | $74.13 | $74.13 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.65 / $50.12 / $50.12
| Facility | | $43.65 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $131.83 / $223.87
| Professional | | $69.18 | $131.83 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $177.83 / $7,079.46
| Facility | | $57.54 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $112.20 / $154.88
| Professional | | $89.13 | $112.20 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,862.09 / $3,467.37
| Facility | | $501.19 | $1,862.09 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $104.71 / $208.93
| Professional | | $66.07 | $104.71 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $5,370.32 / $5,370.32
| Facility | | $5,370.32 | $5,370.32 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $691.83 / $2,818.38
| Facility | | $56.23 | $691.83 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $93.33 / $239.88
| Professional | | $56.23 | $93.33 | $239.88 |
- 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
- $60.26 / $97.72 / $208.93
| Professional | | $60.26 | $97.72 | $208.93 |