- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $3,981.07 / $8,709.64
| Facility | | $1,202.26 | $3,981.07 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $380.19 / $660.69
| Professional | | $204.17 | $380.19 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $6,456.54 / $10,964.78
| Facility | | $3,467.37 | $6,456.54 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $416.87 / $724.44
| Professional | | $251.19 | $416.87 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $1,412.54
| Facility | | $602.56 | $602.56 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $416.87 / $724.44
| Professional | | $245.47 | $416.87 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $467.74 / $1,380.38
| Professional | | $186.21 | $467.74 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $398.11 / $467.74
| Professional | | $186.21 | $398.11 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,981.07 / $7,079.46
| Facility | | $1,348.96 | $3,981.07 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $416.87 / $776.25
| Professional | | $239.88 | $416.87 | $776.25 |