- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.93 / $2,301.54 / $3,515.80
| Facility | | $680.93 | $2,301.54 | $3,515.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.37 / $680.93 / $1,050.81
| Professional | | $354.37 | $680.93 | $1,050.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,039.91 / $2,718.28 / $8,459.92
| Facility | | $2,039.91 | $2,718.28 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $655.71 / $655.71 / $655.71
| Professional | | $655.71 | $655.71 | $655.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $797.77 / $1,241.69 / $2,789.31
| Facility | | $797.77 | $1,241.69 | $2,789.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.62 / $949.14 / $1,901.07
| Professional | | $442.62 | $949.14 | $1,901.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $386.70 / $672.52 / $1,420.70
| Professional | | $386.70 | $672.52 | $1,420.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.50 / $413.50 / $504.39
| Professional | | $413.50 | $413.50 | $504.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.55 / $2,301.54 / $3,471.88
| Facility | | $714.55 | $2,301.54 | $3,471.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $504.38 / $689.33 / $3,471.88
| Professional | | $504.38 | $689.33 | $3,471.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,244.16 / $1,260.97 / $1,681.30
| Professional | | $1,244.16 | $1,260.97 | $1,681.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.28 / $1,398.56 / $2,789.31
| Facility | | $818.28 | $1,398.56 | $2,789.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $623.46 / $949.14 / $1,901.07
| Professional | | $623.46 | $949.14 | $1,901.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.52 / $840.65 / $840.65
| Facility | | $327.52 | $840.65 | $840.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.52 / $840.65 / $840.65
| Professional | | $327.52 | $840.65 | $840.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.07 / $504.39 / $1,176.91
| Professional | | $353.07 | $504.39 | $1,176.91 |