- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $2,818.38 / $5,128.61
| Facility | | $371.54 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $371.54 / $776.25
| Professional | | $234.42 | $371.54 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,041.74 / $5,754.40
| Facility | | $56.23 | $2,041.74 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $457.09 / $1,148.15
| Professional | | $251.19 | $457.09 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $630.96
| Facility | | $275.42 | $275.42 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $478.63 / $891.25
| Professional | | $275.42 | $478.63 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $295.12
| Facility | | $295.12 | $295.12 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $562.34 / $977.24
| Professional | | $288.40 | $562.34 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $426.58 / $7,079.46
| Facility | | $204.17 | $426.58 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $537.03 / $741.31
| Professional | | $426.58 | $537.03 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,981.07 / $9,772.37
| Facility | | $1,698.24 | $3,981.07 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $446.68 / $977.24
| Professional | | $239.88 | $446.68 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,511.89 / $6,165.95
| Facility | | $56.23 | $2,511.89 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $446.68 / $1,122.02
| Professional | | $251.19 | $446.68 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,981.07 / $9,120.11
| Facility | | $1,698.24 | $3,981.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $457.09 / $977.24
| Professional | | $257.04 | $457.09 | $977.24 |