- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $2,570.40 / $7,244.36
| Facility | | $562.34 | $2,570.40 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $575.44 / $1,258.93
| Professional | | $446.68 | $575.44 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $741.31 / $1,071.52
| Professional | | $512.86 | $741.31 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $2,570.40 / $3,548.13
| Professional | | $512.86 | $2,570.40 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $1,659.59
| Facility | | $851.14 | $851.14 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $660.69 / $1,148.15
| Professional | | $489.78 | $660.69 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $794.33 / $954.99
| Professional | | $602.56 | $794.33 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $776.25 / $870.96
| Professional | | $776.25 | $776.25 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $645.65 / $977.24
| Facility | | $467.74 | $645.65 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,019.95 / $3,019.95 / $3,019.95
| Professional | | $3,019.95 | $3,019.95 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $676.08 / $4,073.80
| Facility | | $446.68 | $676.08 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $831.76 / $4,073.80
| Professional | | $537.03 | $831.76 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,467.37 / $5,754.40
| Facility | | $1,737.80 | $3,467.37 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $616.60 / $1,096.48
| Professional | | $416.87 | $616.60 | $1,096.48 |