- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $449.06 / $3,908.01 / $13,841.56
| Facility | | $449.06 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.91 / $377.38 / $1,693.00
| Professional | | $170.91 | $377.38 | $1,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.69 / $343.95 / $343.95
| Professional | | $153.69 | $343.95 | $343.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,514.19 / $3,306.85 / $6,396.51
| Facility | | $2,514.19 | $3,306.85 | $6,396.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.68 / $406.51 / $895.28
| Professional | | $180.68 | $406.51 | $895.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,062.42 / $1,062.42 / $1,062.42
| Facility | | $1,062.42 | $1,062.42 | $1,062.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.17 / $758.53 / $1,152.80
| Professional | | $358.17 | $758.53 | $1,152.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.96 / $449.06 / $1,123.71
| Facility | | $201.96 | $449.06 | $1,123.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.25 / $793.83 / $1,803.81
| Professional | | $514.25 | $793.83 | $1,803.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $418.35 / $913.36 / $1,345.73
| Facility | | $418.35 | $913.36 | $1,345.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.94 / $716.00 / $1,152.80
| Professional | | $358.94 | $716.00 | $1,152.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $382.53 / $719.95 / $1,139.84
| Professional | | $382.53 | $719.95 | $1,139.84 |