- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $3,981.07 / $8,317.64
| Facility | | $104.71 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $91.20 / $275.42
| Professional | | $42.66 | $91.20 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $36.31 / $36.31
| Professional | | $36.31 | $36.31 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $89.13 / $104.71
| Professional | | $70.79 | $89.13 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $97.72 / $186.21
| Professional | | $47.86 | $97.72 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $97.72 / $158.49
| Professional | | $14.45 | $97.72 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $112.20 / $165.96
| Professional | | $50.12 | $112.20 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $457.09 / $1,023.29
| Facility | | $263.03 | $457.09 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $1,513.56 / $8,317.64
| Facility | | $104.71 | $1,513.56 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $97.72 / $251.19
| Professional | | $44.67 | $97.72 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $204.17
| Facility | | $100.00 | $100.00 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $165.96 / $213.80
| Professional | | $95.50 | $165.96 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $93.33 / $158.49
| Facility | | $45.71 | $93.33 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $75.86 / $158.49
| Professional | | $41.69 | $75.86 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $645.65 / $3,890.45
| Facility | | $223.87 | $645.65 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $85.11 / $151.36
| Professional | | $44.67 | $85.11 | $151.36 |