- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.55 / $8,042.03 / $19,276.96
| Facility | | $361.55 | $8,042.03 | $19,276.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.91 / $361.55 / $1,317.66
| Professional | | $231.91 | $361.55 | $1,317.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,712.35 / $6,198.03 / $11,988.99
| Facility | | $4,712.35 | $6,198.03 | $11,988.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.13 / $472.63 / $741.88
| Professional | | $249.13 | $472.63 | $741.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $443.99 / $730.83 / $1,124.83
| Professional | | $443.99 | $730.83 | $1,124.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $276.06 / $481.42 / $1,191.92
| Facility | | $276.06 | $481.42 | $1,191.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $488.23 / $807.70 / $1,896.40
| Professional | | $488.23 | $807.70 | $1,896.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.29 / $846.43 / $2,842.49
| Facility | | $555.29 | $846.43 | $2,842.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.60 / $730.83 / $1,041.26
| Professional | | $514.60 | $730.83 | $1,041.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.18 / $465.85 / $780.77
| Professional | | $267.18 | $465.85 | $780.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $488.23 / $830.88 / $1,051.57
| Professional | | $488.23 | $830.88 | $1,051.57 |