- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,508.00 / $4,072.00 / $9,661.00
| Facility | | $1,508.00 | $4,072.00 | $9,661.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.93 / $302.20 / $336.25
| Professional | | $187.93 | $302.20 | $336.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,691.00 / $3,333.00 / $4,636.00
| Facility | | $1,691.00 | $3,333.00 | $4,636.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.93 / $127.82 / $243.35
| Professional | | $102.93 | $127.82 | $243.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,511.50 / $5,511.50 / $16,534.50
| Facility | | $5,511.50 | $5,511.50 | $16,534.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.10 / $314.10 / $3,479.91
| Facility | | $314.10 | $314.10 | $3,479.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.38 / $1,309.64 / $1,309.64
| Professional | | $262.38 | $1,309.64 | $1,309.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $252.18 / $346.13 / $556.88
| Professional | | $252.18 | $346.13 | $556.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.10 / $555.00 / $3,479.91
| Facility | | $314.10 | $555.00 | $3,479.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.38 / $1,309.64 / $1,309.64
| Professional | | $262.38 | $1,309.64 | $1,309.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,079.00 / $2,826.00 / $4,851.00
| Facility | | $1,079.00 | $2,826.00 | $4,851.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.49 / $364.72 / $860.72
| Professional | | $269.49 | $364.72 | $860.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.01 / $265.45 / $265.45
| Facility | | $261.01 | $265.45 | $265.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.45 / $265.45 / $556.88
| Professional | | $265.45 | $265.45 | $556.88 |