- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $2,818.38 / $3,981.07
| Facility | | $323.59 | $2,818.38 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $380.19 / $831.76
| Professional | | $229.09 | $380.19 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $3,981.07 / $19,498.45
| Facility | | $912.01 | $3,981.07 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $501.19 / $2,754.23
| Professional | | $288.40 | $501.19 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $794.33 / $1,202.26
| Professional | | $457.09 | $794.33 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $741.31 / $3,090.30
| Facility | | $199.53 | $741.31 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $457.09 / $954.99
| Professional | | $245.47 | $457.09 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $616.60 / $7,079.46
| Facility | | $177.83 | $616.60 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $562.34 / $776.25
| Professional | | $416.87 | $562.34 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $3,801.89 / $9,772.37
| Facility | | $524.81 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $691.83 / $1,096.48
| Professional | | $398.11 | $691.83 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $3,890.45 / $5,011.87
| Facility | | $158.49 | $3,890.45 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $3,981.07 / $19,498.45
| Facility | | $912.01 | $3,981.07 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $501.19 / $2,754.23
| Professional | | $281.84 | $501.19 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,890.45 / $9,120.11
| Facility | | $1,071.52 | $3,890.45 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $467.74 / $1,047.13
| Professional | | $257.04 | $467.74 | $1,047.13 |