- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,162.28 / $7,413.10
| Facility | | $1,096.48 | $3,162.28 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $194.98 / $446.68
| Professional | | $151.36 | $194.98 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,548.82 / $3,235.94
| Facility | | $758.58 | $1,548.82 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $229.09 / $354.81
| Professional | | $186.21 | $229.09 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $173.78 / $281.84
| Professional | | $158.49 | $173.78 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $9,772.37 / $11,220.18
| Facility | | $6,309.57 | $9,772.37 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $257.04 / $489.78
| Professional | | $181.97 | $257.04 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $1,380.38 / $16,218.10
| Facility | | $173.78 | $1,380.38 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $251.19 / $1,548.82
| Professional | | $177.83 | $251.19 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,380.38 / $3,235.94
| Facility | | $1,071.52 | $1,380.38 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $218.78 / $354.81
| Professional | | $169.82 | $218.78 | $354.81 |