- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,344.23 / $4,570.88
| Facility | | $1,000.00 | $2,344.23 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,096.48 / $2,041.74 / $10,000.00
| Facility | 50 | $1,096.48 | $2,041.74 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $562.34 / $1,819.70
| Professional | | $398.11 | $562.34 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $5,754.40 / $19,498.45
| Facility | | $1,380.38 | $5,754.40 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $741.31 / $3,981.07
| Professional | | $416.87 | $741.31 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,122.02 / $1,513.56
| Professional | | $1,023.29 | $1,122.02 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $1,000.00 / $1,995.26
| Professional | | $407.38 | $1,000.00 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,122.02 / $7,079.46
| Facility | | $380.19 | $1,122.02 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $758.58 / $1,023.29
| Professional | | $602.56 | $758.58 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $1,000.00 / $1,621.81
| Professional | | $524.81 | $1,000.00 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $5,754.40 / $19,498.45
| Facility | | $1,380.38 | $5,754.40 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $741.31 / $3,981.07
| Professional | | $416.87 | $741.31 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $11,220.18
| Facility | | $2,041.74 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $812.83 / $1,737.80
| Professional | | $489.78 | $812.83 | $1,737.80 |