- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,466.84 / $5,495.41
| Facility | | $2,884.03 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $309.03 / $512.86
| Professional | | $213.80 | $309.03 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $7,762.47 / $17,782.79
| Facility | | $1,737.80 | $7,762.47 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $389.05 / $398.11
| Professional | | $331.13 | $389.05 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $338.84 / $407.38
| Professional | | $245.47 | $338.84 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $457.09 / $4,466.84
| Facility | | $213.80 | $457.09 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $316.23 / $416.87
| Professional | | $199.53 | $316.23 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $77.62
| Professional | | $30.20 | $30.20 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $15,488.17 / $21,379.62
| Facility | | $11,220.18 | $15,488.17 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $389.05 / $416.87
| Professional | | $275.42 | $389.05 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $173.78 / $17,782.79
| Professional | | $169.82 | $173.78 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,982.44 / $18,197.01
| Facility | | $9,332.54 | $16,982.44 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $316.23 / $457.09
| Professional | | $223.87 | $316.23 | $457.09 |