- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $7,244.36 / $14,454.40
| Facility | | $1,047.13 | $7,244.36 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $218.78 / $616.60
| Professional | | $177.83 | $218.78 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $21,379.62 / $57,543.99
| Facility | | $20,417.38 | $21,379.62 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $302.00 / $380.19
| Professional | | $181.97 | $302.00 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $269.15 / $363.08
| Professional | | $181.97 | $269.15 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $295.12
| Professional | | $269.15 | $269.15 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $257.04 / $380.19
| Professional | | $213.80 | $257.04 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $5,370.32 / $13,803.84
| Facility | | $831.76 | $5,370.32 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $245.47 / $616.60
| Professional | | $190.55 | $245.47 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $446.68
| Professional | | $10.00 | $10.00 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $223.87 / $223.87
| Facility | | $177.83 | $223.87 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $223.87 / $588.84
| Professional | | $169.82 | $223.87 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,570.40 / $6,760.83
| Facility | | $660.69 | $2,570.40 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $245.47 / $380.19
| Professional | | $173.78 | $245.47 | $380.19 |