- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $2,884.03 / $8,912.51
| Facility | | $131.83 | $2,884.03 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $91.20 / $177.83
| Professional | | $70.79 | $91.20 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $3,890.45 / $9,549.93
| Facility | | $1,621.81 | $3,890.45 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $95.50 / $186.21
| Professional | | $64.57 | $95.50 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.66 / $141.25 / $630.96
| Facility | | $42.66 | $141.25 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $109.65 / $251.19
| Professional | | $67.61 | $109.65 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,071.52 / $3,467.37
| Facility | | $229.09 | $1,071.52 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $87.10 / $162.18
| Professional | | $60.26 | $87.10 | $162.18 |