- 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
- $130.66 / $147.91 / $321.87
| Professional | | $130.66 | $147.91 | $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
- $358.46 / $558.14 / $1,351.74
| Facility | | $358.46 | $558.14 | $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
- $1,107.88 / $1,682.69 / $1,682.69
| Facility | | $1,107.88 | $1,682.69 | $1,682.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $1,405.89 / $1,682.69
| Professional | | $147.91 | $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
- $358.46 / $630.88 / $1,351.74
| Facility | | $358.46 | $630.88 | $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
- $103.54 / $147.91 / $369.78
| Professional | | $103.54 | $147.91 | $369.78 |