- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,884.03 / $5,623.41
| Facility | | $1,513.56 | $2,884.03 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $275.42 / $977.24
| Professional | | $186.21 | $275.42 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $3,801.89 / $28,840.32
| Facility | | $501.19 | $3,801.89 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $309.03 / $1,949.84
| Professional | | $162.18 | $309.03 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $776.25 / $776.25
| Professional | | $316.23 | $776.25 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $389.05 / $724.44
| Professional | | $223.87 | $389.05 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $501.19 / $7,079.46
| Facility | | $190.55 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $213.80 / $316.23
| Professional | | $112.20 | $213.80 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $354.81 / $575.44
| Professional | | $194.98 | $354.81 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $4,265.80 / $6,606.93
| Facility | | $2,951.21 | $4,265.80 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $354.81
| Professional | | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $3,801.89 / $28,840.32
| Facility | | $501.19 | $3,801.89 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $309.03 / $1,949.84
| Professional | | $162.18 | $309.03 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $8,511.38
| Facility | | $1,584.89 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $331.13 / $812.83
| Professional | | $223.87 | $331.13 | $812.83 |