- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.32 / $1,037.08 / $1,644.18
| Facility | | $315.32 | $1,037.08 | $1,644.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.97 / $299.86 / $530.14
| Professional | | $204.97 | $299.86 | $530.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.16 / $515.63 / $1,411.80
| Facility | | $333.16 | $515.63 | $1,411.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.55 / $451.59 / $1,788.14
| Professional | | $270.55 | $451.59 | $1,788.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.61 / $1,024.75 / $1,791.53
| Facility | | $716.61 | $1,024.75 | $1,791.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.43 / $423.43 / $446.40
| Professional | | $423.43 | $423.43 | $446.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.08 / $551.01 / $1,025.82
| Facility | | $293.08 | $551.01 | $1,025.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.81 / $433.00 / $1,175.50
| Professional | | $265.81 | $433.00 | $1,175.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $650.65 / $650.65 / $765.47
| Professional | | $650.65 | $650.65 | $765.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.91 / $450.91 / $1,396.42
| Professional | | $450.91 | $450.91 | $1,396.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $784.58 / $2,141.82 / $2,141.82
| Facility | | $784.58 | $2,141.82 | $2,141.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.55 / $270.95 / $2,254.55
| Professional | | $270.55 | $270.95 | $2,254.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.38 / $270.95 / $805.35
| Professional | | $189.38 | $270.95 | $805.35 |