- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $2,089.30 / $3,715.35
| Facility | | $371.54 | $2,089.30 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $346.74 / $851.14
| Professional | | $138.04 | $346.74 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $3,162.28 / $19,498.45
| Facility | | $346.74 | $3,162.28 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $407.38 / $1,096.48
| Professional | | $162.18 | $407.38 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $173.78 / $407.38
| Facility | | $173.78 | $173.78 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $436.52 / $794.33
| Professional | | $173.78 | $436.52 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $389.05 / $912.01
| Professional | | $181.97 | $389.05 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $380.19 / $7,079.46
| Facility | | $144.54 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $537.03 / $741.31
| Professional | | $436.52 | $537.03 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $389.05 / $954.99
| Professional | | $169.82 | $389.05 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,819.70 / $1,949.84
| Facility | | $1,047.13 | $1,819.70 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $346.74 / $660.69
| Professional | | $223.87 | $346.74 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $3,162.28 / $19,498.45
| Facility | | $346.74 | $3,162.28 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $407.38 / $1,096.48
| Professional | | $162.18 | $407.38 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $8,511.38
| Facility | | $1,584.89 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $398.11 / $933.25
| Professional | | $169.82 | $398.11 | $933.25 |