- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $478.63 / $1,778.28
| Facility | | $204.17 | $478.63 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $323.59 / $870.96
| Professional | | $91.20 | $323.59 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $5,011.87 / $77,624.71
| Facility | | $1,148.15 | $5,011.87 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64,565.42 / $64,565.42 / $64,565.42
| Professional | | $64,565.42 | $64,565.42 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $208.93 / $575.44
| Facility | | $147.91 | $208.93 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $120.23 / $426.58
| Professional | | $74.13 | $120.23 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38,018.94 / $38,018.94 / $38,018.94
| Professional | | $38,018.94 | $38,018.94 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $251.19 / $407.38
| Facility | | $181.97 | $251.19 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.62 / $18.62 / $93.33
| Professional | | $18.62 | $18.62 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $478.63 / $1,949.84
| Facility | | $138.04 | $478.63 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $398.11 / $933.25
| Professional | | $93.33 | $398.11 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.46 / $14.45 / $32.36
| Facility | | $6.46 | $14.45 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $14.45 / $32.36
| Professional | | $6.46 | $14.45 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $234.42 / $309.03
| Facility | | $131.83 | $234.42 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $102.33 / $338.84
| Professional | | $102.33 | $102.33 | $338.84 |