- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $1,905.46 / $3,715.35
| Facility | | $154.88 | $1,905.46 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $218.78 / $630.96
| Professional | | $123.03 | $218.78 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $2,884.03 / $13,489.63
| Facility | | $389.05 | $2,884.03 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $257.04 / $602.56
| Professional | | $158.49 | $257.04 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $190.55 / $436.52
| Facility | | $190.55 | $190.55 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $323.59 / $537.03
| Professional | | $190.55 | $323.59 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $269.15 / $562.34
| Professional | | $165.96 | $269.15 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $245.47 / $7,079.46
| Facility | | $147.91 | $245.47 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $281.84 / $407.38
| Professional | | $218.78 | $281.84 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $281.84 / $537.03
| Professional | | $173.78 | $281.84 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $831.76 / $1,862.09
| Facility | | $151.36 | $831.76 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $165.96 / $302.00
| Professional | | $147.91 | $165.96 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $2,884.03 / $13,489.63
| Facility | | $389.05 | $2,884.03 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $257.04 / $616.60
| Professional | | $158.49 | $257.04 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $8,511.38
| Facility | | $1,584.89 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $263.03 / $524.81
| Professional | | $165.96 | $263.03 | $524.81 |