- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,584.89 / $8,128.31
| Facility | | $676.08 | $1,584.89 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $630.96 / $1,318.26
| Professional | | $446.68 | $630.96 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $489.78 / $489.78
| Professional | | $489.78 | $489.78 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $1,995.26 / $2,041.74
| Facility | | $1,995.26 | $1,995.26 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $758.58 / $1,621.81
| Professional | | $537.03 | $758.58 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $707.95 / $1,412.54
| Professional | | $416.87 | $707.95 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $691.83 / $1,513.56
| Professional | | $691.83 | $691.83 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $660.69 / $1,071.52
| Facility | | $467.74 | $660.69 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $1,023.29 / $1,380.38
| Professional | | $707.95 | $1,023.29 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,918.31 / $10,471.29
| Facility | | $2,187.76 | $6,918.31 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $616.60 / $1,202.26
| Professional | | $407.38 | $616.60 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $8,912.51 / $45,708.82
| Facility | | $8,912.51 | $8,912.51 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,677.35 / $4,677.35 / $5,495.41
| Professional | | $4,677.35 | $4,677.35 | $5,495.41 |