- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $2,884.03 / $7,762.47
| Facility | | $91.20 | $2,884.03 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $117.49 / $288.40
| Professional | | $56.23 | $117.49 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $10,232.93
| Facility | | $2,630.27 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $125.89 / $331.13
| Professional | | $100.00 | $125.89 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $85.11 / $4,073.80
| Facility | | $85.11 | $85.11 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $85.11 / $186.21
| Professional | | $85.11 | $85.11 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $102.33 / $50,118.72
| Facility | | $34.67 | $102.33 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $165.96 / $457.09
| Professional | | $70.79 | $165.96 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $109.65 / $213.80
| Facility | | $60.26 | $109.65 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $186.21 / $263.03
| Professional | | $138.04 | $186.21 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $147.91 / $316.23
| Professional | | $109.65 | $147.91 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,235.94 / $5,370.32
| Facility | | $1,778.28 | $3,235.94 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $50,118.72 / $75,857.76
| Facility | | $72.44 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $190.55 / $398.11
| Professional | | $154.88 | $190.55 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $5,128.61 / $11,481.54
| Facility | | $2,398.83 | $5,128.61 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $91.20 / $288.40
| Professional | | $38.02 | $91.20 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.98 / $64.57 / $204.17
| Facility | | $48.98 | $64.57 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $147.91 / $269.15
| Professional | | $104.71 | $147.91 | $269.15 |