- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $3,388.44 / $5,370.32
| Facility | | $1,949.84 | $3,388.44 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $1,862.09 / $3,890.45
| Professional | | $380.19 | $1,862.09 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,981.07 / $12,882.50
| Facility | | $56.23 | $3,981.07 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $1,698.24 / $6,025.60
| Professional | | $446.68 | $1,698.24 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $524.81 / $1,230.27
| Facility | | $524.81 | $524.81 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,691.53 / $2,691.53
| Professional | | $2,630.27 | $2,691.53 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $1,949.84 / $5,754.40
| Professional | | $562.34 | $1,949.84 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $851.14 / $7,079.46
| Facility | | $380.19 | $851.14 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,090.30 / $4,168.69
| Professional | | $2,398.83 | $3,090.30 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,888.44 / $13,182.57
| Facility | | $2,344.23 | $5,888.44 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $2,137.96 / $5,495.41
| Professional | | $467.74 | $2,137.96 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $4,897.79 / $13,803.84
| Facility | | $56.23 | $4,897.79 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $1,698.24 / $6,025.60
| Professional | | $457.09 | $1,698.24 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,888.44 / $13,182.57
| Facility | | $2,344.23 | $5,888.44 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $1,862.09 / $5,370.32
| Professional | | $467.74 | $1,862.09 | $5,370.32 |