- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $2,754.23 / $5,623.41
| Facility | | $758.58 | $2,754.23 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $741.31 / $3,388.44
| Professional | | $190.55 | $741.31 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $3,981.07 / $28,840.32
| Facility | | $478.63 | $3,981.07 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $616.60 / $2,454.71
| Professional | | $194.98 | $616.60 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $537.03
| Facility | | $229.09 | $229.09 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $776.25 / $2,290.87
| Professional | | $257.04 | $776.25 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $501.19 / $7,079.46
| Facility | | $177.83 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $912.01 / $1,513.56
| Professional | | $489.78 | $912.01 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $776.25 / $1,949.84
| Professional | | $213.80 | $776.25 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $3,311.31 / $4,466.84
| Facility | | $3,019.95 | $3,311.31 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $371.54
| Professional | | $371.54 | $371.54 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $4,265.80 / $28,840.32
| Facility | | $478.63 | $4,265.80 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $616.60 / $2,398.83
| Professional | | $194.98 | $616.60 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,772.37
| Facility | | $1,862.09 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $724.44 / $2,187.76
| Professional | | $213.80 | $724.44 | $2,187.76 |