- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $380.19 / $3,090.30
| Facility | | $177.83 | $380.19 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $275.42 / $489.78
| Professional | | $144.54 | $275.42 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $13,182.57
| Facility | | $5,011.87 | $7,943.28 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $501.19 / $1,202.26
| Professional | | $239.88 | $501.19 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $954.99 / $1,548.82
| Facility | | $831.76 | $954.99 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $524.81 / $1,096.48
| Professional | | $239.88 | $524.81 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $575.44 / $4,168.69
| Facility | | $177.83 | $575.44 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $478.63 / $891.25
| Professional | | $316.23 | $478.63 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $602.56 / $6,165.95
| Facility | | $177.83 | $602.56 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $524.81 / $2,630.27
| Professional | | $309.03 | $524.81 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $380.19
| Professional | | $32.36 | $33.11 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $467.74 / $1,047.13
| Professional | | $251.19 | $467.74 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,120.11 / $9,120.11
| Facility | | $6,165.95 | $9,120.11 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $660.69 / $2,630.27
| Professional | | $199.53 | $660.69 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $758.58
| Professional | | $354.81 | $354.81 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $891.25 / $1,862.09
| Professional | | $616.60 | $891.25 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,606.93
| Facility | | $2,884.03 | $3,801.89 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $407.38 / $1,071.52
| Professional | | $169.82 | $407.38 | $1,071.52 |