- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,311.31 / $5,623.41
| Facility | | $1,778.28 | $3,311.31 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $616.60 / $977.24
| Professional | | $407.38 | $616.60 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $6,309.57 / $20,892.96
| Facility | | $56.23 | $6,309.57 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $912.01 / $3,890.45
| Professional | | $426.58 | $912.01 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $676.08 / $1,905.46
| Facility | | $50.12 | $676.08 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $891.25 / $1,819.70
| Professional | | $416.87 | $891.25 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,168.69 / $8,511.38
| Facility | | $83.18 | $4,168.69 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $776.25 / $912.01
| Professional | | $776.25 | $776.25 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $6,309.57 / $20,417.38
| Facility | | $1,023.29 | $6,309.57 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $851.14 / $1,380.38
| Professional | | $467.74 | $851.14 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $6,309.57 / $20,892.96
| Facility | | $56.23 | $6,309.57 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $912.01 / $3,890.45
| Professional | | $426.58 | $912.01 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $6,760.83 / $25,703.96
| Facility | | $1,819.70 | $6,760.83 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $912.01 / $1,698.24
| Professional | | $436.52 | $912.01 | $1,698.24 |