- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,981.07 / $8,317.64
| Facility | | $616.60 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $575.44 / $1,258.93
| Professional | | $109.65 | $575.44 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,258.93 / $57,543.99
| Facility | | $1,174.90 | $1,258.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $1,023.29 / $1,548.82
| Professional | | $512.86 | $1,023.29 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $549.54 / $1,348.96
| Professional | | $138.04 | $549.54 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $933.25 / $1,023.29
| Professional | | $724.44 | $933.25 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $851.14 / $1,230.27
| Professional | | $158.49 | $851.14 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,290.87 / $4,073.80
| Facility | | $1,445.44 | $2,290.87 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $3,630.78 / $8,317.64
| Facility | | $724.44 | $3,630.78 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $575.44 / $1,862.09
| Professional | | $114.82 | $575.44 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $1,445.44
| Facility | | $1,023.29 | $1,023.29 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $1,148.15 / $1,819.70
| Professional | | $912.01 | $1,148.15 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $158.49 / $891.25
| Facility | | $123.03 | $158.49 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $158.49 / $891.25
| Professional | | $120.23 | $158.49 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,584.89 / $3,890.45
| Facility | | $501.19 | $1,584.89 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $380.19 / $1,230.27
| Professional | | $120.23 | $380.19 | $1,230.27 |