- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $2,818.38 / $5,128.61
| Facility | | $181.97 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $204.17 / $575.44
| Professional | | $151.36 | $204.17 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $4,897.79 / $28,840.32
| Facility | | $426.58 | $4,897.79 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $275.42 / $691.83
| Professional | | $177.83 | $275.42 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $467.74
| Facility | | $204.17 | $204.17 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $549.54 / $741.31
| Professional | | $346.74 | $549.54 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $346.74 / $660.69
| Professional | | $204.17 | $346.74 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $501.19 / $7,079.46
| Facility | | $158.49 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $239.88 / $389.05
| Professional | | $138.04 | $239.88 | $389.05 |
- 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
- $186.21 / $309.03 / $588.84
| Professional | | $186.21 | $309.03 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,090.30 / $3,090.30
| Facility | | $3,090.30 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $4,897.79 / $28,840.32
| Facility | | $426.58 | $4,897.79 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $275.42 / $691.83
| Professional | | $177.83 | $275.42 | $691.83 |
- 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
- $194.98 / $302.00 / $645.65
| Professional | | $194.98 | $302.00 | $645.65 |