- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.70 / $2,818.38 / $5,623.41
| Facility | | $53.70 | $2,818.38 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $138.04 / $562.34
| Professional | | $57.54 | $138.04 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,398.83 / $4,786.30
| Facility | | $56.23 | $2,398.83 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $162.18 / $446.68
| Professional | | $70.79 | $162.18 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $77.62 / $181.97
| Facility | | $77.62 | $77.62 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $131.83 / $302.00
| Professional | | $131.83 | $131.83 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $190.55 / $426.58
| Professional | | $89.13 | $190.55 | $426.58 |
- 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
- $169.82 / $218.78 / $323.59
| Professional | | $169.82 | $218.78 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $162.18 / $371.54
| Professional | | $69.18 | $162.18 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $141.25
| Professional | | $141.25 | $141.25 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,398.83 / $4,786.30
| Facility | | $56.23 | $2,398.83 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $154.88 / $436.52
| Professional | | $69.18 | $154.88 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $8,511.38
| Facility | | $1,584.89 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $162.18 / $380.19
| Professional | | $74.13 | $162.18 | $380.19 |