- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $2,818.38 / $5,623.41
| Facility | | $436.52 | $2,818.38 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $446.68 / $1,202.26
| Professional | | $281.84 | $446.68 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $3,235.94 / $28,840.32
| Facility | | $691.83 | $3,235.94 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $549.54 / $1,318.26
| Professional | | $323.59 | $549.54 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $794.33
| Facility | | $346.74 | $346.74 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $602.56 / $1,122.02
| Professional | | $346.74 | $602.56 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $575.44 / $1,071.52
| Professional | | $316.23 | $575.44 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $446.68 / $7,079.46
| Facility | | $177.83 | $446.68 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $616.60 / $851.14
| Professional | | $501.19 | $616.60 | $851.14 |
- 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
- $331.13 / $575.44 / $1,122.02
| Professional | | $331.13 | $575.44 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $407.38 / $794.33
| Professional | | $407.38 | $407.38 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $3,235.94 / $28,840.32
| Facility | | $691.83 | $3,235.94 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $549.54 / $1,318.26
| Professional | | $323.59 | $549.54 | $1,318.26 |
- 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
- $331.13 / $562.34 / $1,148.15
| Professional | | $331.13 | $562.34 | $1,148.15 |