- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $2,089.30 / $3,715.35
| Facility | | $114.82 | $2,089.30 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $114.82 / $338.84
| Professional | | $52.48 | $114.82 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,019.95 / $7,943.28
| Facility | | $56.23 | $3,019.95 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $147.91 / $389.05
| Professional | | $67.61 | $147.91 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $72.44 / $169.82
| Facility | | $72.44 | $72.44 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $125.89 / $269.15
| Professional | | $125.89 | $125.89 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $169.82 / $389.05
| Professional | | $85.11 | $169.82 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $380.19 / $7,079.46
| Facility | | $67.61 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $194.98 / $302.00
| Professional | | $154.88 | $194.98 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $151.36 / $338.84
| Professional | | $67.61 | $151.36 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,949.84 / $3,388.44
| Facility | | $1,380.38 | $1,949.84 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,090.30 / $7,943.28
| Facility | | $56.23 | $3,090.30 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $147.91 / $380.19
| Professional | | $66.07 | $147.91 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $10,964.78
| Facility | | $2,041.74 | $5,248.07 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $151.36 / $346.74
| Professional | | $70.79 | $151.36 | $346.74 |