- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.49 / $1,710.08 / $5,554.01
| Facility | | $630.49 | $1,710.08 | $5,554.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $458.15 / $630.49 / $714.55
| Professional | | $458.15 | $630.49 | $714.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.00 / $614.00 / $4,211.66
| Facility | | $203.00 | $614.00 | $4,211.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $617.03 / $863.19 / $1,286.33
| Professional | | $617.03 | $863.19 | $1,286.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $382.49 / $546.41 / $825.80
| Professional | | $382.49 | $546.41 | $825.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.62 / $1,128.35 / $2,751.22
| Facility | | $554.62 | $1,128.35 | $2,751.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $966.01 / $1,024.65 / $1,280.81
| Professional | | $966.01 | $1,024.65 | $1,280.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.00 / $840.65 / $1,345.04
| Professional | | $99.00 | $840.65 | $1,345.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $672.52 / $840.65 / $1,471.14
| Professional | | $672.52 | $840.65 | $1,471.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,462.73 / $3,993.09 / $3,993.09
| Facility | | $1,462.73 | $3,993.09 | $3,993.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.00 / $20.00 / $20.00
| Professional | | $20.00 | $20.00 | $20.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.94 / $1,168.50 / $2,482.39
| Facility | | $562.94 | $1,168.50 | $2,482.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $647.29 / $798.62 / $924.72
| Professional | | $647.29 | $798.62 | $924.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.07 / $353.07 / $1,286.19
| Professional | | $353.07 | $353.07 | $1,286.19 |