- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $177.83 / $295.12
| Facility | | $112.20 | $177.83 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $87.10 / $204.17
| Professional | | $30.20 | $87.10 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $72.44 / $79.43
| Professional | | $60.26 | $72.44 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $58.88 / $58.88
| Facility | | $58.88 | $58.88 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $61.66 / $53,703.18
| Facility | | $61.66 | $61.66 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $100.00 / $154.88
| Professional | | $54.95 | $100.00 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $87.10 / $87.10
| Professional | | $87.10 | $87.10 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $14.13 / $16.60
| Professional | | $14.13 | $14.13 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.48 / $35.48 / $35.48
| Facility | | $35.48 | $35.48 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $34.67 / $107.15
| Professional | | $31.62 | $34.67 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $218.78 / $257.04
| Professional | | $109.65 | $218.78 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $64.57 / $85.11
| Professional | | $46.77 | $64.57 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $16.60 / $36.31
| Professional | | $14.13 | $16.60 | $36.31 |