- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $2,691.53 / $5,128.61
| Facility | | $218.78 | $2,691.53 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $263.03 / $660.69
| Professional | | $194.98 | $263.03 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,951.21 / $13,489.63
| Facility | | $501.19 | $2,951.21 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $338.84 / $812.83
| Professional | | $199.53 | $338.84 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $251.19 / $575.44
| Facility | | $251.19 | $251.19 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $436.52 / $645.65
| Professional | | $251.19 | $436.52 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $354.81 / $630.96
| Professional | | $223.87 | $354.81 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $323.59 / $7,079.46
| Facility | | $177.83 | $323.59 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $338.84 / $467.74
| Professional | | $269.15 | $338.84 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $398.11 / $630.96
| Professional | | $239.88 | $398.11 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $4,466.84 / $4,466.84
| Facility | | $4,466.84 | $4,466.84 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,951.21 / $13,489.63
| Facility | | $501.19 | $2,951.21 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $338.84 / $812.83
| Professional | | $199.53 | $338.84 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,981.07 / $9,120.11
| Facility | | $1,862.09 | $3,981.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $363.08 / $645.65
| Professional | | $223.87 | $363.08 | $645.65 |