- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $2,238.72 / $3,801.89
| Facility | | $331.13 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $316.23 / $724.44
| Professional | | $165.96 | $316.23 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,584.89 / $4,570.88
| Facility | | $56.23 | $1,584.89 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $380.19 / $1,047.13
| Professional | | $181.97 | $380.19 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $194.98 / $457.09
| Facility | | $194.98 | $194.98 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $1,348.96 / $1,348.96
| Professional | | $446.68 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $302.00 / $302.00
| Facility | | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $436.52 / $891.25
| Professional | | $223.87 | $436.52 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $239.88 / $7,079.46
| Facility | | $144.54 | $239.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $478.63 / $660.69
| Professional | | $380.19 | $478.63 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,454.71 / $7,079.46
| Facility | | $794.33 | $2,454.71 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $398.11 / $870.96
| Professional | | $169.82 | $398.11 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,862.09 / $6,165.95
| Facility | | $56.23 | $1,862.09 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $380.19 / $1,023.29
| Professional | | $181.97 | $380.19 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,511.89 / $7,079.46
| Facility | | $794.33 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $380.19 / $851.14
| Professional | | $186.21 | $380.19 | $851.14 |