- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,657.50 / $5,302.44 / $8,155.41
| Facility | | $1,657.50 | $5,302.44 | $8,155.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.75 / $1,579.50 / $1,657.50
| Professional | | $358.75 | $1,579.50 | $1,657.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,521.00 / $1,521.00 / $1,521.00
| Professional | | $1,521.00 | $1,521.00 | $1,521.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,850.55 / $2,880.52 / $6,470.73
| Facility | | $1,850.55 | $2,880.52 | $6,470.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,399.00 / $9,399.00 / $9,399.00
| Professional | | $9,399.00 | $9,399.00 | $9,399.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,047.50 / $2,632.50 / $4,816.50
| Professional | | $2,047.50 | $2,632.50 | $4,816.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,823.25 / $4,607.85 / $8,155.41
| Facility | | $1,823.25 | $4,607.85 | $8,155.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.75 / $1,579.50 / $4,607.85
| Professional | | $358.75 | $1,579.50 | $4,607.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,886.00 / $2,925.00 / $3,900.00
| Professional | | $2,886.00 | $2,925.00 | $3,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,897.88 / $3,191.10 / $6,470.73
| Facility | | $1,897.88 | $3,191.10 | $6,470.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,399.00 / $9,399.00 / $9,399.00
| Professional | | $9,399.00 | $9,399.00 | $9,399.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,950.00 / $1,950.00 / $2,145.00
| Facility | | $1,950.00 | $1,950.00 | $2,145.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,950.00 / $1,950.00 / $2,145.00
| Professional | | $1,950.00 | $1,950.00 | $2,145.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $819.00 / $1,170.00 / $2,603.64
| Professional | | $819.00 | $1,170.00 | $2,603.64 |