- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $3,890.45 / $8,709.64
| Facility | | $588.84 | $3,890.45 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $269.15 / $954.99
| Professional | | $186.21 | $269.15 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $229.09 / $251.19
| Professional | | $181.97 | $229.09 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $6,165.95 / $57,543.99
| Facility | | $5,011.87 | $6,165.95 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $316.23 / $354.81
| Professional | | $302.00 | $316.23 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $263.03 / $416.87
| Professional | | $194.98 | $263.03 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $281.84 / $316.23
| Professional | | $218.78 | $281.84 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $269.15 / $407.38
| Professional | | $204.17 | $269.15 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $4,073.80 / $8,317.64
| Facility | | $1,737.80 | $4,073.80 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $3,090.30 / $8,317.64
| Facility | | $588.84 | $3,090.30 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $302.00 / $691.83
| Professional | | $194.98 | $302.00 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $416.87
| Facility | | $295.12 | $295.12 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $323.59 / $436.52
| Professional | | $251.19 | $323.59 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $309.03 / $407.38
| Facility | | $204.17 | $309.03 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $302.00 / $407.38
| Professional | | $154.88 | $302.00 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,754.23 / $6,606.93
| Facility | | $912.01 | $2,754.23 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $245.47 / $426.58
| Professional | | $181.97 | $245.47 | $426.58 |