- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $2,238.72 / $3,801.89
| Facility | | $38.90 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $39.81 / $72.44
| Professional | | $30.90 | $39.81 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,511.89 / $5,754.40
| Facility | | $56.23 | $2,511.89 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $53.70 / $125.89
| Professional | | $36.31 | $53.70 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $38.02 / $87.10
| Facility | | $38.02 | $38.02 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $64.57 / $93.33
| Professional | | $38.02 | $64.57 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $64.57 / $123.03
| Professional | | $36.31 | $64.57 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.11 / $83.18 / $8,511.38
| Facility | | $33.11 | $83.18 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $54.95 / $75.86
| Professional | | $43.65 | $54.95 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,981.07 / $9,772.37
| Facility | | $1,698.24 | $3,981.07 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $52.48 / $102.33
| Professional | | $33.11 | $52.48 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,570.40 / $5,754.40
| Facility | | $56.23 | $2,570.40 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $53.70 / $125.89
| Professional | | $37.15 | $53.70 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,981.07 / $9,120.11
| Facility | | $1,698.24 | $3,981.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $54.95 / $104.71
| Professional | | $35.48 | $54.95 | $104.71 |