- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $4,786.30 / $8,317.64
| Facility | | $1,047.13 | $4,786.30 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $630.96 / $1,778.28
| Professional | | $512.86 | $630.96 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,047.13 / $1,047.13
| Professional | | $870.96 | $1,047.13 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $707.95 / $1,122.02
| Professional | | $537.03 | $707.95 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $794.33 / $870.96
| Professional | | $616.60 | $794.33 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $724.44 / $1,122.02
| Professional | | $562.34 | $724.44 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $11,748.98 / $19,952.62
| Facility | | $5,248.07 | $11,748.98 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,801.89 / $8,317.64
| Facility | | $954.99 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $758.58 / $1,862.09
| Professional | | $524.81 | $758.58 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $1,148.15
| Facility | | $831.76 | $831.76 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $912.01 / $1,202.26
| Professional | | $758.58 | $912.01 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $691.83 / $933.25
| Facility | | $549.54 | $691.83 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $691.83 / $933.25
| Professional | | $537.03 | $691.83 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,981.07 / $10,964.78
| Facility | | $2,089.30 | $3,981.07 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $660.69 / $1,148.15
| Professional | | $489.78 | $660.69 | $1,148.15 |