- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.48 / $3,019.95 / $9,120.11
| Facility | | $35.48 | $3,019.95 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $26.92 / $77.62
| Professional | | $22.91 | $26.92 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.44 / $28.84 / $63.10
| Professional | | $23.44 | $28.84 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $36.31 / $36.31
| Facility | | $36.31 | $36.31 | $36.31 |
- 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
- $40.74 / $40.74 / $50,118.72
| Facility | | $40.74 | $40.74 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.54 / $42.66 / $104.71
| Professional | | $27.54 | $42.66 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $28.18 / $72.44
| Facility | | $16.98 | $28.18 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.54 / $37.15 / $52.48
| Professional | | $27.54 | $37.15 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.50 / $31.62 / $63.10
| Professional | | $19.50 | $31.62 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $50,118.72 / $75,857.76
| Facility | | $29.51 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $37.15 / $66.07
| Professional | | $30.20 | $37.15 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,754.23 / $4,897.79
| Facility | | $1,318.26 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $28.84 / $67.61
| Professional | | $21.88 | $28.84 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $27.54 / $100.00
| Facility | | $20.42 | $27.54 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $31.62 / $79.43
| Professional | | $20.42 | $31.62 | $79.43 |