- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $2,818.38 / $4,897.79
| Facility | | $446.68 | $2,818.38 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $489.78 / $1,412.54
| Professional | | $302.00 | $489.78 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $3,162.28 / $28,840.32
| Facility | | $794.33 | $3,162.28 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $588.84 / $1,584.89
| Professional | | $263.03 | $588.84 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $912.01
| Facility | | $398.11 | $398.11 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $1,023.29 / $1,071.52
| Professional | | $676.08 | $1,023.29 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $630.96 / $1,258.93
| Professional | | $288.40 | $630.96 | $1,258.93 |
- 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 / $977.24
| Professional | | $645.65 | $794.33 | $977.24 |
- 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
- $389.05 / $707.95 / $1,445.44
| Professional | | $389.05 | $707.95 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $5,248.07 / $5,248.07
| Facility | | $5,248.07 | $5,248.07 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $3,162.28 / $28,840.32
| Facility | | $794.33 | $3,162.28 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $588.84 / $1,584.89
| Professional | | $263.03 | $588.84 | $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
- $275.42 / $616.60 / $1,412.54
| Professional | | $275.42 | $616.60 | $1,412.54 |