- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.29 / $958.59 / $1,635.66
| Facility | | $339.29 | $958.59 | $1,635.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.57 / $337.59 / $486.97
| Professional | | $202.57 | $337.59 | $486.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.18 / $587.19 / $1,296.41
| Facility | | $380.18 | $587.19 | $1,296.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.38 / $416.78 / $1,652.80
| Professional | | $175.38 | $416.78 | $1,652.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.00 / $1,169.74 / $2,045.00
| Facility | | $818.00 | $1,169.74 | $2,045.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.46 / $830.34 / $1,609.10
| Facility | | $334.46 | $830.34 | $1,609.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.62 / $439.59 / $1,125.72
| Professional | | $250.62 | $439.59 | $1,125.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.91 / $833.56 / $6,679.00
| Facility | | $306.91 | $833.56 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.54 / $583.49 / $887.74
| Professional | | $460.54 | $583.49 | $887.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.78 / $416.78 / $1,290.73
| Professional | | $416.78 | $416.78 | $1,290.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.27 / $479.11 / $497.78
| Facility | | $257.27 | $479.11 | $497.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.25 / $78.25 / $78.25
| Professional | | $78.25 | $78.25 | $78.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $732.57 / $1,979.71 / $1,979.71
| Facility | | $732.57 | $1,979.71 | $1,979.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.38 / $250.07 / $2,199.80
| Professional | | $175.38 | $250.07 | $2,199.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.02 / $423.64 / $950.18
| Facility | | $239.02 | $423.64 | $950.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.38 / $250.07 / $784.89
| Professional | | $175.38 | $250.07 | $784.89 |