- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $4,897.79 / $11,481.54
| Facility | | $1,000.00 | $4,897.79 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $154.88 / $177.83
| Professional | | $83.18 | $154.88 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $8,317.64 / $16,982.44
| Facility | | $3,890.45 | $8,317.64 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $245.47 / $575.44
| Professional | | $138.04 | $245.47 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $4,677.35
| Facility | | $275.42 | $275.42 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $309.03 / $776.25
| Professional | | $257.04 | $309.03 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $7,079.46 / $15,488.17
| Facility | | $2,398.83 | $7,079.46 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $194.98 / $354.81
| Professional | | $134.90 | $194.98 | $354.81 |