- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $2,754.23 / $5,128.61
| Facility | | $478.63 | $2,754.23 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $501.19 / $1,047.13
| Professional | | $338.84 | $501.19 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $3,630.78 / $28,840.32
| Facility | | $776.25 | $3,630.78 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $630.96 / $3,801.89
| Professional | | $363.08 | $630.96 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $933.25
| Facility | | $416.87 | $416.87 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $1,659.59 / $1,659.59
| Professional | | $602.56 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $645.65 / $3,090.30
| Facility | | $588.84 | $645.65 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $588.84 / $1,318.26
| Professional | | $346.74 | $588.84 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $676.08 / $7,079.46
| Facility | | $316.23 | $676.08 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $794.33 / $1,122.02
| Professional | | $575.44 | $794.33 | $1,122.02 |
- 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
- $371.54 / $676.08 / $1,348.96
| Professional | | $371.54 | $676.08 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $3,630.78 / $28,840.32
| Facility | | $776.25 | $3,630.78 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $630.96 / $3,801.89
| Professional | | $363.08 | $630.96 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,548.13 / $8,511.38
| Facility | | $676.08 | $3,548.13 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $630.96 / $1,318.26
| Professional | | $354.81 | $630.96 | $1,318.26 |