- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $2,238.72 / $3,801.89
| Facility | | $87.10 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $93.33 / $199.53
| Professional | | $72.44 | $93.33 | $199.53 |
- 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
- $60.26 / $104.71 / $269.15
| Professional | | $60.26 | $104.71 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $83.18 / $190.55
| Facility | | $83.18 | $83.18 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $208.93 / $208.93
| Professional | | $204.17 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.70 / $53.70 / $53.70
| Facility | | $53.70 | $53.70 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $147.91 / $269.15
| Professional | | $72.44 | $147.91 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $177.83 / $7,079.46
| Facility | | $60.26 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $120.23 / $165.96
| Professional | | $95.50 | $120.23 | $165.96 |
- 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
- $70.79 / $112.20 / $229.09
| Professional | | $70.79 | $112.20 | $229.09 |
- 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
- $60.26 / $104.71 / $269.15
| Professional | | $60.26 | $104.71 | $269.15 |
- 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
- $64.57 / $107.15 / $229.09
| Professional | | $64.57 | $107.15 | $229.09 |