- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $458.75 / $2,663.12 / $4,615.51
| Facility | | $458.75 | $2,663.12 | $4,615.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.88 / $458.75 / $973.72
| Professional | | $288.88 | $458.75 | $973.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $734.35 / $2,854.00 / $9,039.00
| Facility | | $734.35 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.37 / $766.64 / $3,359.92
| Professional | | $357.37 | $766.64 | $3,359.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.04 / $476.79 / $851.17
| Facility | | $371.04 | $476.79 | $851.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.58 / $761.68 / $1,165.65
| Professional | | $507.58 | $761.68 | $1,165.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.80 / $658.34 / $1,254.83
| Professional | | $389.80 | $658.34 | $1,254.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $313.64 / $676.56 / $6,679.00
| Facility | | $313.64 | $676.56 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $536.34 / $652.47 / $900.66
| Professional | | $536.34 | $652.47 | $900.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.42 / $854.26 / $1,336.55
| Professional | | $406.42 | $854.26 | $1,336.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,853.72 / $4,115.38 / $9,578.24
| Facility | | $2,853.72 | $4,115.38 | $9,578.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.95 / $446.92 / $492.67
| Professional | | $241.95 | $446.92 | $492.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,589.45 / $3,764.00 / $26,542.00
| Facility | | $1,589.45 | $3,764.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.98 / $982.35 / $3,359.92
| Professional | | $507.98 | $982.35 | $3,359.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.49 / $743.47 / $1,436.12
| Professional | | $486.49 | $743.47 | $1,436.12 |