- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $5,370.32 / $8,511.38
| Facility | | $1,288.25 | $5,370.32 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $199.53 / $741.31
| Professional | | $165.96 | $199.53 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $10,000.00 / $57,543.99
| Facility | | $9,549.93 | $10,000.00 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $257.04 / $257.04
| Professional | | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $223.87 / $338.84
| Professional | | $169.82 | $223.87 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $251.19
| Professional | | $229.09 | $229.09 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $223.87 / $371.54
| Professional | | $181.97 | $223.87 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,570.88 / $8,511.38
| Facility | | $1,023.29 | $4,570.88 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $223.87 / $933.25
| Professional | | $177.83 | $223.87 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $257.04 / $398.11
| Professional | | $245.47 | $257.04 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $251.19 / $426.58
| Facility | | $162.18 | $251.19 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $251.19 / $426.58
| Professional | | $154.88 | $251.19 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $5,495.41 / $25,703.96
| Facility | | $2,454.71 | $5,495.41 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $213.80 / $354.81
| Professional | | $158.49 | $213.80 | $354.81 |