- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $2,691.53 / $3,715.35
| Facility | | $457.09 | $2,691.53 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $478.63 / $1,778.28
| Professional | | $125.89 | $478.63 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $3,548.13
| Facility | | $56.23 | $1,258.93 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $512.86 / $1,819.70
| Professional | | $141.25 | $512.86 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $354.81
| Facility | | $151.36 | $151.36 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $218.78 / $912.01
| Professional | | $181.97 | $218.78 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $489.78 / $1,737.80
| Professional | | $169.82 | $489.78 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $218.78 / $7,079.46
| Facility | | $117.49 | $218.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $870.96 / $1,230.27
| Professional | | $676.08 | $870.96 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,511.89 / $7,079.46
| Facility | | $1,096.48 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $645.65 / $1,584.89
| Professional | | $141.25 | $645.65 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $2,691.53 / $3,890.45
| Facility | | $562.34 | $2,691.53 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $3,548.13
| Facility | | $56.23 | $1,258.93 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $512.86 / $1,819.70
| Professional | | $141.25 | $512.86 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,344.23 / $6,165.95
| Facility | | $954.99 | $2,344.23 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $489.78 / $1,445.44
| Professional | | $154.88 | $489.78 | $1,445.44 |