- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $2,238.72 / $3,801.89
| Facility | | $478.63 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $416.87 / $954.99
| Professional | | $295.12 | $416.87 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,023.29 / $19,498.45
| Facility | | $323.59 | $1,023.29 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $524.81 / $2,951.21
| Professional | | $309.03 | $524.81 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $363.08 / $831.76
| Facility | | $363.08 | $363.08 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $363.08 / $363.08
| Professional | | $204.17 | $363.08 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $602.56
| Facility | | $446.68 | $478.63 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $512.86 / $1,071.52
| Professional | | $288.40 | $512.86 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $616.60 / $7,079.46
| Facility | | $288.40 | $616.60 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $645.65 / $933.25
| Professional | | $446.68 | $645.65 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,819.70 / $3,467.37
| Facility | | $229.09 | $1,819.70 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $575.44 / $1,047.13
| Professional | | $338.84 | $575.44 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,023.29 / $19,498.45
| Facility | | $323.59 | $1,023.29 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $524.81 / $2,951.21
| Professional | | $316.23 | $524.81 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $1,548.82 / $2,818.38
| Facility | | $363.08 | $1,548.82 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $549.54 / $1,047.13
| Professional | | $323.59 | $549.54 | $1,047.13 |