- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.02 / $1,522.13 / $2,061.69
| Facility | | $198.02 | $1,522.13 | $2,061.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.99 / $209.33 / $449.87
| Professional | | $185.99 | $209.33 | $449.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.02 / $323.50 / $2,071.44
| Facility | | $209.02 | $323.50 | $2,071.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.73 / $596.59 / $2,682.75
| Professional | | $169.73 | $596.59 | $2,682.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.88 / $404.52 / $758.68
| Facility | | $282.88 | $404.52 | $758.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.91 / $265.91 / $265.91
| Professional | | $265.91 | $265.91 | $265.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.99 / $483.70 / $1,539.06
| Facility | | $181.99 | $483.70 | $1,539.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.83 / $649.33 / $1,100.86
| Professional | | $405.83 | $649.33 | $1,100.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $3,472.00 / $9,239.00
| Facility | | $83.43 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $975.96 / $975.96 / $1,148.19
| Professional | | $975.96 | $975.96 | $1,148.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.50 / $676.50 / $2,066.51
| Professional | | $676.50 | $676.50 | $2,066.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,177.10 / $3,213.38 / $3,213.38
| Facility | | $1,177.10 | $3,213.38 | $3,213.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.73 / $284.13 / $3,368.97
| Professional | | $169.73 | $284.13 | $3,368.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.73 / $282.88 / $584.66
| Professional | | $169.73 | $282.88 | $584.66 |