- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $4,466.84 / $5,495.41
| Facility | | $1,621.81 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $269.15 / $478.63
| Professional | | $204.17 | $269.15 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $3,467.37 / $9,120.11
| Facility | | $1,412.54 | $3,467.37 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $371.54 / $426.58
| Professional | | $346.74 | $371.54 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $316.23 / $380.19
| Professional | | $218.78 | $316.23 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $380.19 / $707.95
| Facility | | $218.78 | $380.19 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $338.84 / $426.58
| Professional | | $234.42 | $338.84 | $426.58 |
- 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
- $6,025.60 / $7,762.47 / $11,220.18
| Facility | | $6,025.60 | $7,762.47 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $302.00 / $354.81
| Professional | | $251.19 | $302.00 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $346.74 / $7,244.36
| Professional | | $204.17 | $346.74 | $7,244.36 |
- 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
- $199.53 / $281.84 / $416.87
| Professional | | $199.53 | $281.84 | $416.87 |