- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,019.95 / $4,897.79
| Facility | | $676.08 | $3,019.95 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $524.81 / $1,479.11
| Professional | | $109.65 | $524.81 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $3,548.13
| Facility | | $56.23 | $1,258.93 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $512.86 / $1,819.70
| Professional | | $131.83 | $512.86 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $331.13
| Facility | | $141.25 | $141.25 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $281.84 / $1,513.56
| Professional | | $281.84 | $281.84 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $660.69 / $2,137.96
| Professional | | $181.97 | $660.69 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $223.87 / $8,511.38
| Facility | | $107.15 | $223.87 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $912.01 / $1,698.24
| Professional | | $724.44 | $912.01 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,511.89 / $7,079.46
| Facility | | $1,096.48 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $616.60 / $1,513.56
| Professional | | $128.82 | $616.60 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $323.59
| Facility | | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $3,548.13
| Facility | | $56.23 | $1,258.93 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $512.86 / $1,819.70
| Professional | | $131.83 | $512.86 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,344.23 / $6,165.95
| Facility | | $954.99 | $2,344.23 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $616.60 / $1,584.89
| Professional | | $158.49 | $616.60 | $1,584.89 |