- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.09 / $1,027.48 / $1,835.69
| Facility | | $373.09 | $1,027.48 | $1,835.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.52 / $359.92 / $782.37
| Professional | | $276.52 | $359.92 | $782.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,079.59 / $2,771.17 / $8,459.92
| Facility | | $2,079.59 | $2,771.17 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,017.08 / $1,017.08 / $1,017.08
| Professional | | $1,017.08 | $1,017.08 | $1,017.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.70 / $730.23 / $1,568.00
| Facility | | $306.70 | $730.23 | $1,568.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $261.85 / $507.12 / $1,498.36
| Professional | | $261.85 | $507.12 | $1,498.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $201.91 / $900.00 / $2,203.67
| Professional | | $201.91 | $900.00 | $2,203.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $782.37 / $782.37 / $912.77
| Professional | | $782.37 | $782.37 | $912.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.10 / $1,244.34 / $1,835.69
| Facility | | $452.10 | $1,244.34 | $1,835.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.37 / $395.16 / $1,812.78
| Professional | | $342.37 | $395.16 | $1,812.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,929.85 / $1,955.92 / $2,607.90
| Professional | | $1,929.85 | $1,955.92 | $2,607.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $509.44 / $878.72 / $1,647.59
| Facility | | $509.44 | $878.72 | $1,647.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.34 / $527.20 / $1,498.36
| Professional | | $415.34 | $527.20 | $1,498.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.93 / $438.93 / $709.78
| Facility | | $438.93 | $438.93 | $709.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.93 / $438.93 / $709.78
| Professional | | $438.93 | $438.93 | $709.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.35 / $274.06 / $933.26
| Professional | | $184.35 | $274.06 | $933.26 |