- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $2,754.23 / $5,128.61
| Facility | | $186.21 | $2,754.23 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $239.88 / $707.95
| Professional | | $151.36 | $239.88 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $5,011.87 / $28,840.32
| Facility | | $436.52 | $5,011.87 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $302.00 / $776.25
| Professional | | $181.97 | $302.00 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $489.78
| Facility | | $213.80 | $213.80 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $371.54 / $676.08
| Professional | | $213.80 | $371.54 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $501.19 / $7,079.46
| Facility | | $181.97 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $389.05 / $562.34
| Professional | | $309.03 | $389.05 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $346.74 / $741.31
| Professional | | $213.80 | $346.74 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,691.53 / $2,691.53
| Facility | | $1,905.46 | $2,691.53 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $5,011.87 / $28,840.32
| Facility | | $436.52 | $5,011.87 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $302.00 / $794.33
| Professional | | $181.97 | $302.00 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,549.93
| Facility | | $1,862.09 | $4,265.80 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $331.13 / $645.65
| Professional | | $190.55 | $331.13 | $645.65 |