- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $1,819.70 / $7,079.46
| Facility | | $257.04 | $1,819.70 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $398.11 / $851.14
| Professional | | $177.83 | $398.11 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $269.15 / $457.09
| Professional | | $181.97 | $269.15 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $281.84 / $2,511.89
| Professional | | $181.97 | $281.84 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $416.87
| Facility | | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $398.11 / $776.25
| Professional | | $186.21 | $398.11 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $645.65 / $776.25
| Professional | | $501.19 | $645.65 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $645.65 / $1,122.02
| Professional | | $524.81 | $645.65 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $398.11 / $776.25
| Facility | | $186.21 | $398.11 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $223.87
| Professional | | $223.87 | $223.87 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $239.88 / $3,162.28
| Facility | | $173.78 | $239.88 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $537.03 / $3,162.28
| Professional | | $380.19 | $537.03 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,311.31 / $5,754.40
| Facility | | $1,737.80 | $3,311.31 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $331.13 / $758.58
| Professional | | $154.88 | $331.13 | $758.58 |