- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $3,801.89 / $12,589.25
| Facility | | $407.38 | $3,801.89 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $218.78 / $741.31
| Professional | | $138.04 | $218.78 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $4,073.80 / $7,943.28
| Facility | | $3,090.30 | $4,073.80 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $245.47 / $380.19
| Professional | | $151.36 | $245.47 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $398.11 / $575.44
| Professional | | $288.40 | $398.11 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $281.84 / $3,715.35
| Facility | | $123.03 | $281.84 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $363.08 / $977.24
| Professional | | $257.04 | $363.08 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $426.58 / $549.54
| Professional | | $302.00 | $426.58 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $398.11 / $457.09
| Professional | | $288.40 | $398.11 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $3,162.28 / $8,128.31
| Facility | | $2,630.27 | $3,162.28 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $288.40 / $467.74
| Professional | | $181.97 | $288.40 | $467.74 |