- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,145.78 / $7,838.38
| Facility | | $1,000.00 | $2,145.78 | $7,838.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.49 / $1,023.86 / $25,364.80
| Professional | | $933.49 | $1,023.86 | $25,364.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $85.00 / $1,103.66
| Professional | | $50.00 | $85.00 | $1,103.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.63 / $772.17 / $1,142.95
| Facility | | $535.63 | $772.17 | $1,142.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.00 / $1,158.00 / $1,401.00
| Facility | | $230.00 | $1,158.00 | $1,401.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.67 / $1,409.74 / $2,046.94
| Professional | | $603.67 | $1,409.74 | $2,046.94 |