- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $2,238.72 / $3,801.89
| Facility | | $131.83 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $154.88 / $501.19
| Professional | | $93.33 | $154.88 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,047.13 / $2,818.38
| Facility | | $56.23 | $1,047.13 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $229.09 / $588.84
| Professional | | $114.82 | $229.09 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $134.90 / $316.23
| Facility | | $134.90 | $134.90 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $194.98 / $338.84
| Professional | | $128.82 | $194.98 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $234.42 / $489.78
| Professional | | $123.03 | $234.42 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $218.78 / $7,079.46
| Facility | | $104.71 | $218.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $295.12 / $426.58
| Professional | | $229.09 | $295.12 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $263.03 / $562.34
| Professional | | $123.03 | $263.03 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,047.13 / $2,818.38
| Facility | | $56.23 | $1,047.13 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $229.09 / $602.56
| Professional | | $114.82 | $229.09 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $2,818.38
| Facility | | $630.96 | $1,862.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $229.09 / $489.78
| Professional | | $123.03 | $229.09 | $489.78 |