- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,981.07 / $9,332.54
| Facility | | $1,584.89 | $3,981.07 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $66.07 / $85.11
| Professional | | $47.86 | $66.07 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $120.23 / $223.87
| Professional | | $100.00 | $120.23 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $53,703.18
| Facility | | $346.74 | $346.74 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,737.80 / $1,737.80 / $1,737.80
| Professional | | $1,737.80 | $1,737.80 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $91.20 / $218.78
| Facility | | $57.54 | $91.20 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $870.96 / $1,230.27
| Professional | | $707.95 | $870.96 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $309.03 / $524.81
| Professional | | $100.00 | $309.03 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $3,311.31 / $6,165.95
| Facility | | $1,479.11 | $3,311.31 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $53.70 / $446.68
| Professional | | $31.62 | $53.70 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $162.18 / $162.18
| Facility | | $100.00 | $162.18 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $229.09 / $501.19
| Professional | | $100.00 | $229.09 | $501.19 |