- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.39 / $1,946.42 / $2,579.09
| Facility | | $592.39 | $1,946.42 | $2,579.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556.41 / $592.39 / $994.96
| Professional | | $556.41 | $592.39 | $994.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.91 / $978.01 / $2,649.67
| Facility | | $631.91 | $978.01 | $2,649.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.76 / $846.27 / $3,355.99
| Professional | | $507.76 | $846.27 | $3,355.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $846.27 / $1,210.17 / $2,269.69
| Facility | | $846.27 | $1,210.17 | $2,269.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $795.49 / $795.49 / $795.49
| Professional | | $795.49 | $795.49 | $795.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $544.47 / $611.46 / $1,925.28
| Facility | | $544.47 | $611.46 | $1,925.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.54 / $892.68 / $2,205.76
| Professional | | $439.54 | $892.68 | $2,205.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $3,669.84 / $9,239.00
| Facility | | $83.43 | $3,669.84 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,221.01 / $1,221.01 / $1,436.48
| Professional | | $1,221.01 | $1,221.01 | $1,436.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $846.27 / $846.27 / $2,620.81
| Professional | | $846.27 | $846.27 | $2,620.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,472.51 / $4,019.78 / $4,019.78
| Facility | | $1,472.51 | $4,019.78 | $4,019.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.76 / $507.76 / $4,231.35
| Professional | | $507.76 | $507.76 | $4,231.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.76 / $507.76 / $1,480.97
| Professional | | $507.76 | $507.76 | $1,480.97 |