- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $3,235.94 / $8,912.51
| Facility | | $380.19 | $3,235.94 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $436.52 / $776.25
| Professional | | $281.84 | $436.52 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $407.38 / $575.44
| Professional | | $281.84 | $407.38 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $2,290.87 / $3,548.13
| Professional | | $275.42 | $2,290.87 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $436.52 / $776.25
| Professional | | $269.15 | $436.52 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $524.81 / $660.69
| Professional | | $257.04 | $524.81 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $676.08 / $691.83
| Professional | | $660.69 | $676.08 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $478.63 / $758.58
| Facility | | $281.84 | $478.63 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $371.54 / $8,709.64
| Facility | | $251.19 | $371.54 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $588.84 / $8,709.64
| Professional | | $398.11 | $588.84 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,244.36 / $14,125.38
| Facility | | $3,890.45 | $7,244.36 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $371.54 / $691.83
| Professional | | $223.87 | $371.54 | $691.83 |