- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,311.31 / $5,623.41
| Facility | | $676.08 | $3,311.31 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $512.86 / $1,288.25
| Professional | | $398.11 | $512.86 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,162.28 / $45,708.82
| Facility | | $1,023.29 | $3,162.28 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $676.08 / $4,168.69
| Professional | | $407.38 | $676.08 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $933.25 / $1,230.27
| Professional | | $537.03 | $933.25 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $691.83 / $1,258.93
| Professional | | $446.68 | $691.83 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $933.25 / $7,079.46
| Facility | | $426.58 | $933.25 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $602.56 / $812.83
| Professional | | $478.63 | $602.56 | $812.83 |
- 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
- $436.52 / $812.83 / $1,288.25
| Professional | | $436.52 | $812.83 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $4,365.16 / $4,570.88
| Facility | | $724.44 | $4,365.16 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $891.25 / $891.25
| Professional | | $891.25 | $891.25 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,162.28 / $45,708.82
| Facility | | $1,071.52 | $3,162.28 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $676.08 / $4,168.69
| Professional | | $407.38 | $676.08 | $4,168.69 |
- 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
- $457.09 / $676.08 / $1,318.26
| Professional | | $457.09 | $676.08 | $1,318.26 |