- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,388.44 / $10,000.00
| Facility | | $1,000.00 | $3,388.44 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $1,862.09 / $7,762.47
| Professional | | $363.08 | $1,862.09 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $398.11 / $10,000.00
| Facility | | $34.67 | $398.11 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,238.72 / $2,238.72
| Professional | | $2,238.72 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,454.71 / $4,168.69
| Facility | | $1,513.56 | $2,454.71 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $676.08 / $954.99
| Professional | | $512.86 | $676.08 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $1,584.89 / $4,168.69
| Facility | | $269.15 | $1,584.89 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $39.81 / $60.26
| Professional | | $34.67 | $39.81 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $512.86
| Professional | | $512.86 | $512.86 | $512.86 |