- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $4,677.35 / $10,471.29
| Facility | | $131.83 | $4,677.35 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $173.78 / $575.44
| Professional | | $81.28 | $173.78 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,162.28 / $10,471.29
| Facility | | $2,137.96 | $3,162.28 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $173.78 / $316.23
| Professional | | $107.15 | $173.78 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $173.78 / $316.23
| Professional | | $102.33 | $173.78 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $218.78 / $218.78
| Professional | | $208.93 | $218.78 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $380.19
| Facility | | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $141.25
| Professional | | $141.25 | $141.25 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $3,890.45 / $6,760.83
| Facility | | $1,288.25 | $3,890.45 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $138.04 / $263.03
| Professional | | $74.13 | $138.04 | $263.03 |