- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $3,388.44 / $5,623.41
| Facility | | $1,445.44 | $3,388.44 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,659.59 / $4,365.16
| Professional | | $1,412.54 | $1,659.59 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,715.35 / $20,892.96
| Facility | | $56.23 | $3,715.35 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,380.38 / $2,238.72 / $10,715.19
| Professional | | $1,380.38 | $2,238.72 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $741.31 / $1,380.38
| Facility | | $50.12 | $741.31 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,122.02 / $2,041.74 / $4,073.80
| Professional | | $1,122.02 | $2,041.74 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $2,238.72 / $8,511.38
| Facility | | $302.00 | $2,238.72 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,041.74 / $3,090.30
| Professional | | $1,479.11 | $2,041.74 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $5,888.44 / $15,488.17
| Facility | | $851.14 | $5,888.44 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,570.40 / $3,890.45
| Professional | | $1,445.44 | $2,570.40 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,715.35 / $20,892.96
| Facility | | $56.23 | $3,715.35 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,380.38 / $2,238.72 / $10,715.19
| Professional | | $1,380.38 | $2,238.72 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $6,165.95 / $14,125.38
| Facility | | $1,698.24 | $6,165.95 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,137.96 / $4,265.80
| Professional | | $1,445.44 | $2,137.96 | $4,265.80 |