- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $2,089.30 / $3,715.35
| Facility | | $158.49 | $2,089.30 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $165.96 / $467.74
| Professional | | $112.20 | $165.96 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,096.48 / $3,548.13
| Facility | | $56.23 | $1,096.48 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $199.53 / $467.74
| Professional | | $120.23 | $199.53 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $134.90 / $309.03
| Facility | | $134.90 | $134.90 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $281.84 / $436.52
| Professional | | $190.55 | $281.84 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $234.42 / $389.05
| Professional | | $138.04 | $234.42 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $218.78 / $7,079.46
| Facility | | $102.33 | $218.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $239.88 / $323.59
| Professional | | $194.98 | $239.88 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,511.89 / $7,079.46
| Facility | | $1,096.48 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $223.87 / $446.68
| Professional | | $125.89 | $223.87 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,096.48 / $3,548.13
| Facility | | $56.23 | $1,096.48 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $199.53 / $467.74
| Professional | | $120.23 | $199.53 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,344.23 / $6,165.95
| Facility | | $954.99 | $2,344.23 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $213.80 / $446.68
| Professional | | $128.82 | $213.80 | $446.68 |