- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $547.97 / $1,839.54 / $2,829.33
| Facility | | $547.97 | $1,839.54 | $2,829.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424.21 / $547.97 / $4,349.89
| Professional | | $424.21 | $547.97 | $4,349.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,441.98 / $3,254.06 / $8,459.92
| Facility | | $2,441.98 | $3,254.06 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $527.66 / $527.66 / $527.66
| Professional | | $527.66 | $527.66 | $527.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $642.01 / $999.35 / $2,244.92
| Facility | | $642.01 | $999.35 | $2,244.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.60 / $624.76 / $1,227.88
| Professional | | $311.60 | $624.76 | $1,227.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.52 / $913.28 / $1,285.34
| Professional | | $402.52 | $913.28 | $1,285.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,362.40 / $1,362.40 / $1,362.40
| Facility | | $1,362.40 | $1,362.40 | $1,362.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $547.97 / $1,725.09 / $2,793.95
| Facility | | $547.97 | $1,725.09 | $2,793.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.77 / $575.03 / $2,793.95
| Professional | | $480.77 | $575.03 | $2,793.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,001.22 / $1,014.75 / $1,353.00
| Professional | | $1,001.22 | $1,014.75 | $1,353.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $658.34 / $1,125.49 / $2,244.92
| Facility | | $658.34 | $1,125.49 | $2,244.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.02 / $650.27 / $1,232.57
| Professional | | $317.02 | $650.27 | $1,232.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.50 / $676.50 / $777.72
| Facility | | $676.50 | $676.50 | $777.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.50 / $676.50 / $777.72
| Professional | | $676.50 | $676.50 | $777.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.13 / $405.90 / $1,014.75
| Professional | | $284.13 | $405.90 | $1,014.75 |