- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $2,754.23 / $5,128.61
| Facility | | $309.03 | $2,754.23 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $302.00 / $660.69
| Professional | | $173.78 | $302.00 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $724.44 / $28,840.32
| Facility | | $199.53 | $724.44 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $354.81 / $2,187.76
| Professional | | $190.55 | $354.81 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $218.78 / $501.19
| Facility | | $218.78 | $218.78 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $204.17
| Professional | | $151.36 | $151.36 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $588.84 / $645.65
| Facility | | $218.78 | $588.84 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $363.08 / $758.58
| Professional | | $194.98 | $363.08 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $512.86 / $7,079.46
| Facility | | $234.42 | $512.86 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $616.60 / $891.25
| Professional | | $426.58 | $616.60 | $891.25 |
- 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
- $275.42 / $512.86 / $1,023.29
| Professional | | $275.42 | $512.86 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $724.44 / $28,840.32
| Facility | | $199.53 | $724.44 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $354.81 / $2,187.76
| Professional | | $190.55 | $354.81 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $1,071.52 / $2,818.38
| Facility | | $309.03 | $1,071.52 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $363.08 / $954.99
| Professional | | $190.55 | $363.08 | $954.99 |