- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $4,265.80 / $5,495.41
| Facility | | $354.81 | $4,265.80 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $295.12 / $691.83
| Professional | | $134.90 | $295.12 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,235.94 / $5,248.07
| Facility | | $1,778.28 | $3,235.94 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $457.09 / $562.34
| Professional | | $245.47 | $457.09 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $269.15 / $537.03
| Professional | | $158.49 | $269.15 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $398.11 / $1,621.81
| Facility | | $169.82 | $398.11 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $316.23 / $562.34
| Professional | | $158.49 | $316.23 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $5,011.87 / $6,456.54
| Facility | | $3,630.78 | $5,011.87 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $251.19 / $501.19
| Professional | | $177.83 | $251.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $257.04 / $4,897.79
| Professional | | $245.47 | $257.04 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $12,302.69 / $12,302.69
| Facility | | $5,495.41 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $288.40 / $512.86
| Professional | | $144.54 | $288.40 | $512.86 |