- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.66 / $5,116.62 / $20,680.40
| Facility | | $205.66 | $5,116.62 | $20,680.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.66 / $225.67 / $315.83
| Professional | | $205.66 | $225.67 | $315.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,409.54 / $5,750.27 / $10,681.81
| Facility | | $3,409.54 | $5,750.27 | $10,681.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.99 / $490.26 / $1,800.30
| Professional | | $287.99 | $490.26 | $1,800.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.71 / $2,137.71 / $3,561.41
| Facility | | $2,137.71 | $2,137.71 | $3,561.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.98 / $291.98 / $291.98
| Professional | | $291.98 | $291.98 | $291.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,793.31 / $3,257.64 / $20,921.22
| Facility | | $1,793.31 | $3,257.64 | $20,921.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $631.27 / $2,399.52 / $4,284.79
| Professional | | $631.27 | $2,399.52 | $4,284.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.00 / $50.00 / $50.00
| Professional | | $45.00 | $50.00 | $50.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $1,314.70 / $1,929.47
| Facility | | $223.87 | $1,314.70 | $1,929.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.45 / $281.97 / $848.85
| Facility | | $265.45 | $281.97 | $848.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.24 / $470.24 / $578.30
| Professional | | $290.24 | $470.24 | $578.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,179.46 / $5,682.43 / $10,681.81
| Facility | | $4,179.46 | $5,682.43 | $10,681.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.73 / $429.97 / $585.32
| Professional | | $270.73 | $429.97 | $585.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $3,509.00 / $17,644.00
| Facility | | $2,912.00 | $3,509.00 | $17,644.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.29 / $410.91 / $596.66
| Professional | | $258.29 | $410.91 | $596.66 |