- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $3,388.44 / $5,370.32
| Facility | | $467.74 | $3,388.44 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $489.78 / $1,071.52
| Professional | | $302.00 | $489.78 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $4,897.79 / $33,884.42
| Facility | | $776.25 | $4,897.79 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $602.56 / $1,479.11
| Professional | | $363.08 | $602.56 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $891.25
| Facility | | $389.05 | $389.05 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $676.08 / $1,258.93
| Professional | | $389.05 | $676.08 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $630.96 / $1,202.26
| Professional | | $354.81 | $630.96 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $707.95 / $7,079.46
| Facility | | $316.23 | $707.95 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $691.83 / $954.99
| Professional | | $549.54 | $691.83 | $954.99 |
- 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
- $371.54 / $645.65 / $1,258.93
| Professional | | $371.54 | $645.65 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $269.15
| Professional | | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $4,897.79 / $33,884.42
| Facility | | $776.25 | $4,897.79 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $602.56 / $1,479.11
| Professional | | $363.08 | $602.56 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,772.37
| Facility | | $1,862.09 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $630.96 / $1,288.25
| Professional | | $371.54 | $630.96 | $1,288.25 |