- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $364.91 / $1,271.26 / $3,494.58
| Facility | | $364.91 | $1,271.26 | $3,494.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.16 / $403.83 / $413.56
| Professional | | $265.16 | $403.83 | $413.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.00 / $614.00 / $2,437.57
| Facility | | $244.00 | $614.00 | $2,437.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.83 / $672.63 / $1,099.60
| Professional | | $288.83 | $672.63 | $1,099.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.38 / $316.25 / $790.78
| Professional | | $221.38 | $316.25 | $790.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $320.99 / $685.00 / $1,592.32
| Facility | | $320.99 | $685.00 | $1,592.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,599.84 / $1,640.24 / $1,807.50
| Professional | | $1,599.84 | $1,640.24 | $1,807.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.54 / $559.52 / $656.83
| Professional | | $486.54 | $559.52 | $656.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.89 / $559.52 / $929.29
| Professional | | $437.89 | $559.52 | $929.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $846.58 / $2,311.07 / $2,311.07
| Facility | | $846.58 | $2,311.07 | $2,311.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,422.96 / $2,422.96 / $3,649.05
| Professional | | $2,422.96 | $2,422.96 | $3,649.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.31 / $583.85 / $1,290.93
| Facility | | $395.31 | $583.85 | $1,290.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.54 / $535.19 / $1,637.82
| Professional | | $486.54 | $535.19 | $1,637.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.23 / $496.27 / $827.12
| Professional | | $389.23 | $496.27 | $827.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.35 / $486.54 / $486.54
| Facility | | $204.35 | $486.54 | $486.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.35 / $212.60 / $1,171.54
| Professional | | $204.35 | $212.60 | $1,171.54 |