- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.23 / $1,699.53 / $3,238.63
| Facility | | $389.23 | $1,699.53 | $3,238.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.18 / $374.26 / $423.86
| Professional | | $338.18 | $374.26 | $423.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $475.00 / $876.00 / $2,245.08
| Facility | | $475.00 | $876.00 | $2,245.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.36 / $232.66 / $431.06
| Professional | | $180.36 | $232.66 | $431.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.40 / $595.20 / $4,044.66
| Facility | | $59.40 | $595.20 | $4,044.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.16 / $293.08 / $736.80
| Professional | | $205.16 | $293.08 | $736.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.50 / $756.17 / $1,509.41
| Facility | | $306.50 | $756.17 | $1,509.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.91 / $541.09 / $721.46
| Professional | | $450.91 | $541.09 | $721.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.82 / $518.54 / $982.98
| Professional | | $405.82 | $518.54 | $982.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $784.58 / $2,141.82 / $2,141.82
| Facility | | $784.58 | $2,141.82 | $2,141.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,254.55 / $2,254.55 / $3,381.83
| Professional | | $2,254.55 | $2,254.55 | $3,381.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.73 / $541.09 / $1,196.39
| Facility | | $360.73 | $541.09 | $1,196.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.91 / $496.00 / $676.37
| Professional | | $450.91 | $496.00 | $676.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.91 / $450.91 / $450.91
| Professional | | $450.91 | $450.91 | $450.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.38 / $202.91 / $1,256.51
| Professional | | $189.38 | $202.91 | $1,256.51 |