- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $3,090.30 / $5,128.61
| Facility | | $338.84 | $3,090.30 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $309.03 / $588.84
| Professional | | $173.78 | $309.03 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $4,897.79 / $45,708.82
| Facility | | $436.52 | $4,897.79 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $416.87 / $1,023.29
| Professional | | $204.17 | $416.87 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $218.78 / $512.86
| Facility | | $218.78 | $218.78 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $426.58 / $812.83
| Professional | | $218.78 | $426.58 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $575.44 / $7,079.46
| Facility | | $181.97 | $575.44 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $467.74 / $676.08
| Professional | | $380.19 | $467.74 | $676.08 |
- 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
- $208.93 / $389.05 / $831.76
| Professional | | $208.93 | $389.05 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $4,897.79 / $45,708.82
| Facility | | $436.52 | $4,897.79 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $416.87 / $1,023.29
| Professional | | $204.17 | $416.87 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $12,302.69
| Facility | | $1,862.09 | $4,265.80 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $416.87 / $831.76
| Professional | | $208.93 | $416.87 | $831.76 |