- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.77 / $1,740.10 / $2,446.19
| Facility | | $473.77 | $1,740.10 | $2,446.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.83 / $473.77 / $3,760.91
| Professional | | $432.83 | $473.77 | $3,760.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,494.06 / $3,323.47 / $8,459.92
| Facility | | $2,494.06 | $3,323.47 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.22 / $456.22 / $456.22
| Professional | | $456.22 | $456.22 | $456.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.08 / $863.91 / $1,940.67
| Facility | | $555.08 | $863.91 | $1,940.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.43 / $562.14 / $1,254.14
| Professional | | $308.43 | $562.14 | $1,254.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.02 / $789.62 / $1,111.31
| Professional | | $348.02 | $789.62 | $1,111.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,001.45 / $2,001.45 / $2,001.45
| Facility | | $2,001.45 | $2,001.45 | $2,001.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.17 / $1,658.19 / $2,446.19
| Facility | | $497.17 | $1,658.19 | $2,446.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.83 / $497.17 / $2,415.64
| Professional | | $432.83 | $497.17 | $2,415.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $865.65 / $877.35 / $1,169.80
| Professional | | $865.65 | $877.35 | $1,169.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $569.24 / $973.10 / $1,940.67
| Facility | | $569.24 | $973.10 | $1,940.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.56 / $617.15 / $1,258.93
| Professional | | $311.56 | $617.15 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.90 / $584.90 / $794.31
| Facility | | $584.90 | $584.90 | $794.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.90 / $584.90 / $794.31
| Professional | | $584.90 | $584.90 | $794.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.66 / $350.94 / $1,070.36
| Professional | | $245.66 | $350.94 | $1,070.36 |