- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,467.37 / $10,232.93
| Facility | | $1,000.00 | $3,467.37 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $2,691.53 / $8,128.31
| Professional | | $616.60 | $2,691.53 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $4,168.69 / $15,135.61
| Facility | | $1,122.02 | $4,168.69 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $7,244.36
| Professional | | $0.02 | $0.02 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $398.11 / $2,511.89
| Facility | | $34.67 | $398.11 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,238.72 / $14,791.08
| Professional | | $1,318.26 | $2,238.72 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $1,071.52 / $3,548.13
| Facility | | $204.17 | $1,071.52 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $63.10 / $407.38
| Professional | | $39.81 | $63.10 | $407.38 |