- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $1,995.26 / $8,709.64
| Facility | | $177.83 | $1,995.26 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $218.78 / $707.95
| Professional | | $125.89 | $218.78 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $213.80 / $346.74
| Professional | | $131.83 | $213.80 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $112.20 / $2,570.40
| Professional | | $97.72 | $112.20 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $645.65 / $831.76
| Facility | | $524.81 | $645.65 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $229.09 / $398.11
| Professional | | $131.83 | $229.09 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $275.42 / $457.09
| Professional | | $223.87 | $275.42 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Professional | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $223.87 / $389.05
| Facility | | $131.83 | $223.87 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $54.95 / $54.95
| Professional | | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $165.96 / $2,454.71
| Facility | | $125.89 | $165.96 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $263.03 / $2,454.71
| Professional | | $204.17 | $263.03 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,818.38 / $5,754.40
| Facility | | $512.86 | $2,818.38 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $194.98 / $331.13
| Professional | | $117.49 | $194.98 | $331.13 |