- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.15 / $979.46 / $3,150.33
| Facility | | $338.15 | $979.46 | $3,150.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.49 / $338.15 / $491.49
| Professional | | $322.49 | $338.15 | $491.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.14 / $628.60 / $1,698.41
| Facility | | $326.14 | $628.60 | $1,698.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.54 / $357.56 / $870.94
| Professional | | $214.54 | $357.56 | $870.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.14 / $1,003.46 / $1,754.30
| Facility | | $630.14 | $1,003.46 | $1,754.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.11 / $336.11 / $454.09
| Professional | | $336.11 | $336.11 | $454.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $249.85 / $539.42 / $1,380.43
| Facility | | $249.85 | $539.42 | $1,380.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.56 / $410.94 / $653.10
| Professional | | $210.56 | $410.94 | $653.10 |
- 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
- $515.75 / $515.75 / $606.77
| Professional | | $515.75 | $515.75 | $606.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.56 / $495.58 / $1,330.92
| Professional | | $357.56 | $495.58 | $1,330.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,194.30 / $3,194.30 / $3,194.30
| Facility | | $3,194.30 | $3,194.30 | $3,194.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $628.60 / $1,698.41 / $1,698.41
| Facility | | $628.60 | $1,698.41 | $1,698.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.90 / $214.54 / $731.91
| Professional | | $160.90 | $214.54 | $731.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.63 / $235.92 / $731.91
| Professional | | $171.63 | $235.92 | $731.91 |