- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $1,348.96 / $6,606.93
| Facility | | $363.08 | $1,348.96 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $489.78 / $1,096.48
| Professional | | $181.97 | $489.78 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $2,041.74
| Facility | | $1,445.44 | $1,445.44 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $501.19 / $1,412.54
| Professional | | $245.47 | $501.19 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $467.74 / $1,445.44
| Professional | | $309.03 | $467.74 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $575.44 / $1,258.93
| Facility | | $186.21 | $575.44 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $676.08 / $1,412.54
| Professional | | $302.00 | $676.08 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $489.78 / $1,230.27
| Facility | | $181.97 | $489.78 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $501.19 / $1,412.54
| Professional | | $239.88 | $501.19 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $3,715.35 / $4,466.84
| Facility | | $2,818.38 | $3,715.35 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $912.01 / $1,380.38
| Professional | | $346.74 | $912.01 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $4,897.79 / $7,244.36
| Facility | | $1,548.82 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $602.56 / $1,412.54
| Professional | | $281.84 | $602.56 | $1,412.54 |