- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $2,818.38 / $5,623.41
| Facility | | $151.36 | $2,818.38 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $257.04 / $489.78
| Professional | | $151.36 | $257.04 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $457.09 / $2,818.38
| Facility | | $56.23 | $457.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $338.84 / $912.01
| Professional | | $186.21 | $338.84 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $467.74
| Facility | | $204.17 | $204.17 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $371.54 / $707.95
| Professional | | $194.98 | $371.54 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $302.00 / $7,079.46
| Facility | | $162.18 | $302.00 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $478.63 / $616.60
| Professional | | $389.05 | $478.63 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $407.38 / $831.76
| Professional | | $194.98 | $407.38 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $457.09 / $2,818.38
| Facility | | $56.23 | $457.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $338.84 / $912.01
| Professional | | $186.21 | $338.84 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $1,819.70 / $2,818.38
| Facility | | $407.38 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $346.74 / $776.25
| Professional | | $194.98 | $346.74 | $776.25 |