- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $3,630.78 / $7,585.78
| Facility | | $1,949.84 | $3,630.78 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $467.74 / $1,513.56
| Professional | | $363.08 | $467.74 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $5,248.07 / $33,884.42
| Facility | | $954.99 | $5,248.07 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $616.60 / $4,677.35
| Professional | | $389.05 | $616.60 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $812.83 / $1,122.02
| Professional | | $478.63 | $812.83 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $912.01 / $3,715.35
| Facility | | $831.76 | $912.01 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $549.54 / $1,122.02
| Professional | | $331.13 | $549.54 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $851.14 / $7,079.46
| Facility | | $398.11 | $851.14 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $575.44 / $831.76
| Professional | | $416.87 | $575.44 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $4,570.88 / $11,220.18
| Facility | | $645.65 | $4,570.88 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $741.31 / $1,148.15
| Professional | | $407.38 | $741.31 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $4,365.16 / $4,365.16
| Facility | | $4,365.16 | $4,365.16 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $5,248.07 / $33,884.42
| Facility | | $954.99 | $5,248.07 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $616.60 / $4,677.35
| Professional | | $389.05 | $616.60 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $4,786.30 / $10,232.93
| Facility | | $1,479.11 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $575.44 / $1,202.26
| Professional | | $389.05 | $575.44 | $1,202.26 |