- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $3,388.44 / $5,623.41
| Facility | | $1,318.26 | $3,388.44 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,398.83 / $3,715.35
| Professional | | $1,318.26 | $2,398.83 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,778.28 / $15,488.17
| Facility | | $56.23 | $1,778.28 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,235.94 / $16,218.10
| Professional | | $1,737.80 | $3,235.94 | $16,218.10 |
- 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
- $416.87 / $2,951.21 / $7,079.46
| Professional | | $416.87 | $2,951.21 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $3,630.78 / $8,511.38
| Facility | | $83.18 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $2,951.21
| Professional | | $2,454.71 | $2,454.71 | $2,951.21 |
- 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
- $1,659.59 / $2,951.21 / $4,466.84
| Professional | | $1,659.59 | $2,951.21 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,778.28 / $15,488.17
| Facility | | $56.23 | $1,778.28 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,235.94 / $16,218.10
| Professional | | $1,737.80 | $3,235.94 | $16,218.10 |
- 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
- $1,698.24 / $3,019.95 / $5,011.87
| Professional | | $1,698.24 | $3,019.95 | $5,011.87 |