- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.04 / $1,426.01 / $1,682.69
| Facility | | $627.04 | $1,426.01 | $1,682.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.72 / $99.31 / $321.87
| Professional | | $87.72 | $99.31 | $321.87 |
- 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
- $317.80 / $317.80 / $317.80
| Professional | | $317.80 | $317.80 | $317.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.77 / $529.66 / $1,351.74
| Facility | | $272.77 | $529.66 | $1,351.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,963.81 / $1,963.81 / $1,963.81
| Professional | | $1,963.81 | $1,963.81 | $1,963.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.80 / $550.03 / $1,006.35
| Professional | | $427.80 | $550.03 | $1,006.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $833.46 / $833.46 / $1,098.51
| Facility | | $833.46 | $833.46 | $1,098.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.04 / $1,682.69 / $1,682.69
| Facility | | $627.04 | $1,682.69 | $1,682.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.31 / $1,405.89 / $1,682.69
| Professional | | $99.31 | $1,405.89 | $1,682.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.00 / $611.14 / $814.86
| Professional | | $603.00 | $611.14 | $814.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.77 / $542.55 / $1,351.74
| Facility | | $272.77 | $542.55 | $1,351.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,963.81 / $1,963.81 / $1,963.81
| Professional | | $1,963.81 | $1,963.81 | $1,963.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.43 / $407.43 / $448.17
| Facility | | $407.43 | $407.43 | $448.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.43 / $407.43 / $448.17
| Professional | | $407.43 | $407.43 | $448.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.51 / $99.31 / $333.11
| Professional | | $69.51 | $99.31 | $333.11 |