- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $2,187.76 / $3,801.89
| Facility | | $398.11 | $2,187.76 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $457.09 / $1,122.02
| Professional | | $371.54 | $457.09 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,398.83 / $19,498.45
| Facility | | $630.96 | $2,398.83 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $602.56 / $1,513.56
| Professional | | $354.81 | $602.56 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $489.78 / $1,122.02
| Facility | | $489.78 | $489.78 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $660.69 / $1,202.26
| Professional | | $407.38 | $660.69 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $870.96 / $7,079.46
| Facility | | $380.19 | $870.96 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $691.83 / $912.01
| Professional | | $549.54 | $691.83 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $776.25 / $1,258.93
| Professional | | $478.63 | $776.25 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $2,398.83 / $19,498.45
| Facility | | $691.83 | $2,398.83 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $602.56 / $1,513.56
| Professional | | $363.08 | $602.56 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $4,073.80
| Facility | | $630.96 | $2,041.74 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $630.96 / $1,288.25
| Professional | | $407.38 | $630.96 | $1,288.25 |