- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.62 / $1,348.31 / $3,983.03
| Facility | | $515.62 | $1,348.31 | $3,983.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.96 / $569.49 / $923.50
| Professional | | $430.96 | $569.49 | $923.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.67 / $5.50 / $515.62
| Professional | | $4.67 | $5.50 | $515.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $769.58 / $769.58
| Facility | | $80.00 | $769.58 | $769.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.36 / $1,390.64 / $3,277.08
| Facility | | $342.36 | $1,390.64 | $3,277.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.95 / $731.10 / $1,211.70
| Professional | | $389.95 | $731.10 | $1,211.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,231.33 / $3,655.51 / $3,655.51
| Facility | | $1,231.33 | $3,655.51 | $3,655.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,847.90 / $3,847.90 / $5,771.85
| Professional | | $3,847.90 | $3,847.90 | $5,771.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $469.44 / $769.58 / $1,154.36
| Facility | | $469.44 | $769.58 | $1,154.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $769.58 / $769.58 / $961.98
| Professional | | $769.58 | $769.58 | $961.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.23 / $923.50 / $1,731.56
| Professional | | $500.23 | $923.50 | $1,731.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.96 / $836.38 / $2,512.27
| Facility | | $430.96 | $836.38 | $2,512.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.41 / $885.02 / $1,211.70
| Professional | | $392.41 | $885.02 | $1,211.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.22 / $323.22 / $492.53
| Professional | | $323.22 | $323.22 | $492.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.14 / $769.58 / $1,038.93
| Professional | | $300.14 | $769.58 | $1,038.93 |