- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.11 / $2,663.12 / $4,806.64
| Facility | | $41.11 | $2,663.12 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.11 / $90.32 / $283.49
| Professional | | $41.11 | $90.32 | $283.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.55 / $953.00 / $2,733.00
| Facility | | $103.55 | $953.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.18 / $146.62 / $682.48
| Professional | | $56.18 | $146.62 | $682.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.29 / $69.28 / $135.88
| Facility | | $53.29 | $69.28 | $135.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.53 / $118.38 / $249.92
| Professional | | $81.53 | $118.38 | $249.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.69 / $154.13 / $308.05
| Professional | | $72.69 | $154.13 | $308.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.17 / $168.26 / $6,679.00
| Facility | | $54.17 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.35 / $138.16 / $247.04
| Professional | | $109.35 | $138.16 | $247.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.93 / $125.19 / $257.35
| Professional | | $57.93 | $125.19 | $257.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.65 / $320.26 / $320.26
| Professional | | $82.65 | $320.26 | $320.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.10 / $255.71 / $682.48
| Professional | | $116.10 | $255.71 | $682.48 |
- 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
- $104.64 / $152.05 / $395.78
| Professional | | $104.64 | $152.05 | $395.78 |