- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $2,818.38 / $5,128.61
| Facility | | $446.68 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $524.81 / $1,380.38
| Professional | | $338.84 | $524.81 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $1,412.54 / $28,840.32
| Facility | | $354.81 | $1,412.54 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $707.95 / $1,778.28
| Professional | | $436.52 | $707.95 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $489.78 / $1,122.02
| Facility | | $489.78 | $489.78 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $831.76 / $1,584.89
| Professional | | $489.78 | $831.76 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $831.76 / $7,079.46
| Facility | | $389.05 | $831.76 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $870.96 / $1,258.93
| Professional | | $691.83 | $870.96 | $1,258.93 |
- 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
- $457.09 / $776.25 / $1,621.81
| Professional | | $457.09 | $776.25 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $1,412.54 / $28,840.32
| Facility | | $398.11 | $1,412.54 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $707.95 / $1,819.70
| Professional | | $436.52 | $707.95 | $1,819.70 |
- 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
- $446.68 / $758.58 / $1,479.11
| Professional | | $446.68 | $758.58 | $1,479.11 |