- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $2,691.53 / $4,897.79
| Facility | | $389.05 | $2,691.53 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $426.58 / $977.24
| Professional | | $281.84 | $426.58 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $4,570.88 / $28,840.32
| Facility | | $724.44 | $4,570.88 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $512.86 / $1,348.96
| Professional | | $309.03 | $512.86 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $831.76
| Facility | | $371.54 | $371.54 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $870.96 / $870.96
| Professional | | $630.96 | $870.96 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $575.44 / $1,071.52
| Professional | | $302.00 | $575.44 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $630.96 / $7,079.46
| Facility | | $295.12 | $630.96 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $616.60 / $851.14
| Professional | | $501.19 | $616.60 | $851.14 |
- 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
- $338.84 / $588.84 / $1,096.48
| Professional | | $338.84 | $588.84 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $2,884.03 / $2,884.03
| Facility | | $2,884.03 | $2,884.03 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $4,570.88 / $28,840.32
| Facility | | $724.44 | $4,570.88 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $512.86 / $1,348.96
| Professional | | $316.23 | $512.86 | $1,348.96 |
- 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
- $323.59 / $537.03 / $1,148.15
| Professional | | $323.59 | $537.03 | $1,148.15 |