- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.22 / $2,063.16 / $2,500.62
| Facility | | $508.22 | $2,063.16 | $2,500.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.75 / $484.31 / $508.22
| Professional | | $358.75 | $484.31 | $508.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,065.12 / $2,751.88 / $8,459.92
| Facility | | $2,065.12 | $2,751.88 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.37 / $466.37 / $466.37
| Professional | | $466.37 | $466.37 | $466.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.41 / $869.39 / $1,984.14
| Facility | | $567.41 | $869.39 | $1,984.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,881.93 / $2,881.93 / $2,881.93
| Professional | | $2,881.93 | $2,881.93 | $2,881.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $627.80 / $807.18 / $1,476.84
| Professional | | $627.80 | $807.18 | $1,476.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.85 / $1,697.45 / $2,469.37
| Facility | | $615.85 | $1,697.45 | $2,469.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.41 / $508.22 / $2,469.37
| Professional | | $392.41 | $508.22 | $2,469.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $884.91 / $896.87 / $1,195.82
| Professional | | $884.91 | $896.87 | $1,195.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $581.83 / $925.28 / $1,984.14
| Facility | | $581.83 | $925.28 | $1,984.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,881.93 / $2,881.93 / $2,881.93
| Professional | | $2,881.93 | $2,881.93 | $2,881.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.91 / $597.91 / $657.70
| Facility | | $597.91 | $597.91 | $657.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $597.91 / $597.91 / $657.70
| Professional | | $597.91 | $597.91 | $657.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $538.12 / $717.49 / $717.49
| Facility | | $538.12 | $717.49 | $717.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.12 / $358.75 / $837.07
| Professional | | $251.12 | $358.75 | $837.07 |