- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $3,311.31 / $9,772.37
| Facility | | $354.81 | $3,311.31 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $380.19 / $851.14
| Professional | | $234.42 | $380.19 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,888.44 / $12,302.69
| Facility | | $3,388.44 | $5,888.44 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $407.38 / $977.24
| Professional | | $323.59 | $407.38 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,995.26 / $8,912.51
| Facility | | $346.74 | $1,995.26 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $562.34
| Professional | | $346.74 | $346.74 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $426.58 / $50,118.72
| Facility | | $426.58 | $426.58 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $489.78 / $1,288.25
| Professional | | $257.04 | $489.78 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $346.74 / $912.01
| Facility | | $275.42 | $346.74 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $616.60 / $870.96
| Professional | | $446.68 | $616.60 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $363.08 / $363.08
| Facility | | $363.08 | $363.08 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $501.19 / $831.76
| Professional | | $309.03 | $501.19 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $354.81
| Professional | | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $50,118.72 / $75,857.76
| Facility | | $275.42 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $524.81 / $1,047.13
| Professional | | $398.11 | $524.81 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $4,365.16 / $9,549.93
| Facility | | $2,041.74 | $4,365.16 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $389.05 / $1,000.00
| Professional | | $229.09 | $389.05 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $302.00 / $1,230.27
| Facility | | $208.93 | $302.00 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $478.63 / $912.01
| Professional | | $316.23 | $478.63 | $912.01 |