- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,884.03 / $5,128.61
| Facility | | $1,513.56 | $2,884.03 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $138.04 / $338.84
| Professional | | $117.49 | $138.04 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $3,162.28 / $28,840.32
| Facility | | $309.03 | $3,162.28 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $204.17 / $1,513.56
| Professional | | $114.82 | $204.17 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $199.53 / $371.54
| Professional | | $131.83 | $199.53 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $501.19 / $7,079.46
| Facility | | $154.88 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $213.80 / $257.04
| Professional | | $169.82 | $213.80 | $257.04 |
- 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
- $158.49 / $295.12 / $467.74
| Professional | | $158.49 | $295.12 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $3,162.28 / $28,840.32
| Facility | | $309.03 | $3,162.28 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $204.17 / $1,513.56
| Professional | | $114.82 | $204.17 | $1,513.56 |
- 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
- $128.82 / $208.93 / $446.68
| Professional | | $128.82 | $208.93 | $446.68 |