- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.14 / $1,052.59 / $1,369.61
| Facility | | $303.14 | $1,052.59 | $1,369.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.14 / $393.83 / $1,204.63
| Professional | | $303.14 | $393.83 | $1,204.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.35 / $1,031.67 / $3,149.44
| Facility | | $473.35 | $1,031.67 | $3,149.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.47 / $569.96 / $14,817.33
| Professional | | $369.47 | $569.96 | $14,817.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $783.34 / $1,239.34 / $2,089.16
| Facility | | $783.34 | $1,239.34 | $2,089.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.67 / $830.23 / $1,404.09
| Professional | | $496.67 | $830.23 | $1,404.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.93 / $49,922.00 / $56,064.00
| Facility | | $489.93 | $49,922.00 | $56,064.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.81 / $799.99 / $1,338.28
| Professional | | $476.81 | $799.99 | $1,338.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $433.87 / $905.62 / $6,679.00
| Facility | | $433.87 | $905.62 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $488.10 / $616.77 / $917.57
| Professional | | $488.10 | $616.77 | $917.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $527.55 / $974.40 / $1,344.75
| Professional | | $527.55 | $974.40 | $1,344.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.71 / $586.32 / $865.18
| Professional | | $363.71 | $586.32 | $865.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,149.44 / $3,149.44 / $3,935.04
| Facility | | $3,149.44 | $3,149.44 | $3,935.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.97 / $603.72 / $14,817.33
| Professional | | $416.97 | $603.72 | $14,817.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.60 / $569.96 / $981.67
| Professional | | $407.60 | $569.96 | $981.67 |