- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,388.44 / $5,623.41
| Facility | | $1,071.52 | $3,388.44 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,318.26 / $3,548.13
| Professional | | $1,071.52 | $1,318.26 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,089.30 / $11,220.18
| Facility | | $56.23 | $2,089.30 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,737.80 / $8,912.51
| Professional | | $1,047.13 | $1,737.80 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,511.89 / $3,311.31
| Professional | | $1,659.59 | $2,511.89 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $676.08 / $1,380.38
| Facility | | $50.12 | $676.08 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $1,584.89 / $3,235.94
| Professional | | $588.84 | $1,584.89 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $1,995.26 / $8,511.38
| Facility | | $302.00 | $1,995.26 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,778.28 / $2,511.89
| Professional | | $1,288.25 | $1,778.28 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $2,454.71 / $4,677.35
| Facility | | $295.12 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,258.93 / $2,187.76 / $3,311.31
| Professional | | $1,258.93 | $2,187.76 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,089.30 / $11,220.18
| Facility | | $56.23 | $2,089.30 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,737.80 / $8,912.51
| Professional | | $1,071.52 | $1,737.80 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,754.23 / $4,677.35
| Facility | | $794.33 | $2,754.23 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,698.24 / $3,548.13
| Professional | | $1,096.48 | $1,698.24 | $3,548.13 |