- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $1,905.46 / $3,715.35
| Facility | | $309.03 | $1,905.46 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $478.63 / $2,454.71
| Professional | | $77.62 | $478.63 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $501.19 / $2,818.38
| Facility | | $56.23 | $501.19 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $478.63 / $1,737.80
| Professional | | $91.20 | $478.63 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $234.42
| Facility | | $100.00 | $100.00 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $199.53 / $1,412.54
| Professional | | $199.53 | $199.53 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $676.08 / $2,041.74
| Professional | | $138.04 | $676.08 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $501.19 / $7,079.46
| Facility | | $83.18 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $831.76 / $1,584.89
| Professional | | $660.69 | $831.76 | $1,584.89 |
- 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
- $91.20 / $562.34 / $1,380.38
| Professional | | $91.20 | $562.34 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $194.98 / $416.87
| Facility | | $194.98 | $194.98 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $501.19 / $2,818.38
| Facility | | $56.23 | $501.19 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $478.63 / $1,737.80
| Professional | | $91.20 | $478.63 | $1,737.80 |
- 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
- $107.15 / $371.54 / $1,479.11
| Professional | | $107.15 | $371.54 | $1,479.11 |