- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $4,466.84 / $8,912.51
| Facility | | $416.87 | $4,466.84 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $575.44 / $4,677.35
| Professional | | $275.42 | $575.44 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,698.24 / $3,090.30
| Facility | | $831.76 | $1,698.24 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $3,162.28 / $4,466.84
| Professional | | $489.78 | $3,162.28 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $630.96 / $5,128.61
| Professional | | $331.13 | $630.96 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $933.25 / $7,413.10
| Facility | | $309.03 | $933.25 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $707.95 / $5,370.32
| Professional | | $316.23 | $707.95 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,398.83 / $3,715.35
| Facility | | $1,698.24 | $2,398.83 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $724.44 / $6,025.60
| Professional | | $426.58 | $724.44 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $2,454.71 / $4,677.35
| Professional | | $269.15 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $6,165.95 / $7,762.47
| Facility | | $3,467.37 | $6,165.95 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $660.69 / $4,466.84
| Professional | | $323.59 | $660.69 | $4,466.84 |