- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $2,691.53 / $4,897.79
| Facility | | $125.89 | $2,691.53 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $173.78 / $436.52
| Professional | | $70.79 | $173.78 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,096.48 / $4,677.35
| Facility | | $56.23 | $1,096.48 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $208.93 / $645.65
| Professional | | $77.62 | $208.93 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $83.18 / $194.98
| Facility | | $83.18 | $83.18 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $194.98 / $446.68
| Professional | | $83.18 | $194.98 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $1,122.02
| Facility | | $676.08 | $741.31 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $213.80 / $489.78
| Professional | | $87.10 | $213.80 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $380.19 / $7,079.46
| Facility | | $83.18 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $363.08 / $512.86
| Professional | | $269.15 | $363.08 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $234.42 / $616.60
| Professional | | $85.11 | $234.42 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,096.48 / $4,677.35
| Facility | | $56.23 | $1,096.48 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $208.93 / $645.65
| Professional | | $77.62 | $208.93 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,691.53 / $8,511.38
| Facility | | $676.08 | $2,691.53 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $194.98 / $575.44
| Professional | | $81.28 | $194.98 | $575.44 |