- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $2,511.89 / $7,585.78
| Facility | | $691.83 | $2,511.89 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $707.95 / $1,122.02
| Professional | | $602.56 | $707.95 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $794.33 / $1,071.52
| Professional | | $630.96 | $794.33 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $588.84 / $602.56
| Facility | | $79.43 | $588.84 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $891.25 / $1,380.38
| Professional | | $660.69 | $891.25 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $1,995.26 / $4,265.80
| Facility | | $1,995.26 | $1,995.26 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,897.79 / $5,888.44 / $5,888.44
| Professional | | $4,897.79 | $5,888.44 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $977.24 / $4,073.80
| Facility | | $588.84 | $977.24 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $812.83 / $1,071.52
| Professional | | $616.60 | $812.83 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $87.10 / $575.44
| Professional | | $32.36 | $87.10 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,202.26 / $2,137.96 / $2,344.23
| Professional | | $1,202.26 | $2,137.96 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $794.33 / $1,445.44
| Facility | | $588.84 | $794.33 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $891.25 / $1,380.38
| Professional | | $645.65 | $891.25 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $1,047.13 / $2,691.53
| Facility | | $158.49 | $1,047.13 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $707.95 / $1,122.02
| Professional | | $537.03 | $707.95 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $630.96 / $630.96
| Professional | | $575.44 | $630.96 | $630.96 |