- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,230.27 / $1,445.44
| Facility | | $1,096.48 | $1,230.27 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $977.24 / $1,348.96
| Professional | | $28.84 | $977.24 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.30 / $1,513.56 / $3,715.35
| Facility | | $26.30 | $1,513.56 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $954.99 / $3,019.95
| Professional | | $26.92 | $954.99 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.74 / $1,548.82 / $2,041.74
| Facility | | $40.74 | $1,548.82 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $1,548.82 / $2,691.53
| Professional | | $40.74 | $1,548.82 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,071.52 / $1,071.52
| Professional | | $1,071.52 | $1,071.52 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $31.62 / $40.74
| Facility | | $30.90 | $31.62 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,187.76 / $3,162.28
| Professional | | $1,584.89 | $2,187.76 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $831.76 / $3,311.31
| Professional | | $37.15 | $831.76 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.30 / $1,513.56 / $3,715.35
| Facility | | $26.30 | $1,513.56 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $977.24 / $3,090.30
| Professional | | $26.92 | $977.24 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,621.81 / $2,570.40
| Professional | | $1,047.13 | $1,621.81 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $2,187.76 / $2,290.87
| Facility | | $1,023.29 | $2,187.76 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $1,122.02 / $3,090.30
| Professional | | $26.30 | $1,122.02 | $3,090.30 |