- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,884.03 / $5,128.61
| Facility | | $1,513.56 | $2,884.03 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $151.36 / $446.68
| Professional | | $112.20 | $151.36 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,071.52 / $28,840.32
| Facility | | $346.74 | $1,071.52 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $263.03 / $2,398.83
| Professional | | $138.04 | $263.03 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $245.47 / $512.86
| Professional | | $173.78 | $245.47 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $501.19 / $7,079.46
| Facility | | $154.88 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $199.53 / $288.40
| Professional | | $154.88 | $199.53 | $288.40 |
- 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
- $158.49 / $281.84 / $426.58
| Professional | | $158.49 | $281.84 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $1,071.52 / $28,840.32
| Facility | | $363.08 | $1,071.52 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $263.03 / $2,398.83
| Professional | | $125.89 | $263.03 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,819.70 / $2,818.38
| Facility | | $575.44 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $269.15 / $426.58
| Professional | | $169.82 | $269.15 | $426.58 |