- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $3,090.30 / $5,128.61
| Facility | | $478.63 | $3,090.30 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $478.63 / $954.99
| Professional | | $295.12 | $478.63 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,754.23 / $45,708.82
| Facility | | $794.33 | $2,754.23 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $616.60 / $1,584.89
| Professional | | $338.84 | $616.60 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $407.38 / $912.01
| Facility | | $407.38 | $407.38 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $676.08 / $1,288.25
| Professional | | $338.84 | $676.08 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $707.95 / $7,079.46
| Facility | | $323.59 | $707.95 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $794.33 / $1,096.48
| Professional | | $645.65 | $794.33 | $1,096.48 |
- 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
- $380.19 / $691.83 / $1,412.54
| Professional | | $380.19 | $691.83 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,754.23 / $45,708.82
| Facility | | $794.33 | $2,754.23 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $616.60 / $1,584.89
| Professional | | $338.84 | $616.60 | $1,584.89 |
- 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
- $354.81 / $645.65 / $1,412.54
| Professional | | $354.81 | $645.65 | $1,412.54 |