- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $1,380.38 / $3,715.35
| Facility | | $218.78 | $1,380.38 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $331.13 / $1,000.00
| Professional | | $169.82 | $331.13 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $758.58 / $2,818.38
| Facility | | $141.25 | $758.58 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $354.81 / $912.01
| Professional | | $190.55 | $354.81 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $524.81
| Facility | | $234.42 | $234.42 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $416.87 / $812.83
| Professional | | $234.42 | $416.87 | $812.83 |
- 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
- $234.42 / $426.58 / $776.25
| Professional | | $234.42 | $426.58 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $380.19 / $7,079.46
| Facility | | $173.78 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $426.58 / $602.56
| Professional | | $323.59 | $426.58 | $602.56 |
- 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
- $204.17 / $371.54 / $758.58
| Professional | | $204.17 | $371.54 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $489.78 / $1,862.09
| Facility | | $269.15 | $489.78 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $512.86 / $2,089.30
| Professional | | $436.52 | $512.86 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $758.58 / $2,818.38
| Facility | | $141.25 | $758.58 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $354.81 / $933.25
| Professional | | $190.55 | $354.81 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $478.63 / $630.96
| Professional | | $234.42 | $478.63 | $630.96 |
- 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
- $204.17 / $363.08 / $691.83
| Professional | | $204.17 | $363.08 | $691.83 |