- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.28 / $1,262.09 / $3,500.61
| Facility | | $530.28 | $1,262.09 | $3,500.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.77 / $378.77 / $777.83
| Professional | | $378.77 | $378.77 | $777.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.40 / $1,465.46 / $4,051.46
| Facility | | $694.40 | $1,465.46 | $4,051.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.37 / $676.37 / $1,100.22
| Professional | | $676.37 | $676.37 | $1,100.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.56 / $1,552.53 / $3,013.65
| Facility | | $450.56 | $1,552.53 | $3,013.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.48 / $823.90 / $987.13
| Professional | | $358.48 | $823.90 | $987.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,082.19 / $3,212.76 / $3,212.76
| Facility | | $1,082.19 | $3,212.76 | $3,212.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,381.85 / $3,381.85 / $5,072.78
| Professional | | $3,381.85 | $3,381.85 | $5,072.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.82 / $676.37 / $951.51
| Facility | | $405.82 | $676.37 | $951.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $642.54 / $676.37 / $845.46
| Professional | | $642.54 | $676.37 | $845.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.64 / $845.46 / $2,367.30
| Professional | | $439.64 | $845.46 | $2,367.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $459.42 / $710.19 / $2,435.35
| Facility | | $459.42 | $710.19 | $2,435.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.10 / $811.64 / $1,183.65
| Professional | | $541.10 | $811.64 | $1,183.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.08 / $284.08 / $432.88
| Professional | | $284.08 | $284.08 | $432.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.36 / $263.77 / $676.37
| Professional | | $180.36 | $263.77 | $676.37 |