- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $2,238.72 / $3,801.89
| Facility | | $263.03 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $288.40 / $630.96
| Professional | | $181.97 | $288.40 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $4,677.35
| Facility | | $56.23 | $1,258.93 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $363.08 / $2,187.76
| Professional | | $186.21 | $363.08 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $239.88 / $549.54
| Facility | | $239.88 | $239.88 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $954.99 / $954.99
| Professional | | $933.25 | $954.99 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $446.68 / $501.19
| Facility | | $199.53 | $446.68 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $371.54 / $758.58
| Professional | | $186.21 | $371.54 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $436.52 / $7,079.46
| Facility | | $204.17 | $436.52 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $478.63 / $676.08
| Professional | | $346.74 | $478.63 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $407.38 / $812.83
| Professional | | $229.09 | $407.38 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $4,677.35
| Facility | | $56.23 | $1,258.93 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $363.08 / $2,187.76
| Professional | | $186.21 | $363.08 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,162.28 / $8,511.38
| Facility | | $676.08 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $354.81 / $794.33
| Professional | | $181.97 | $354.81 | $794.33 |