- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,145.78 / $7,838.38
| Facility | | $1,000.00 | $2,145.78 | $7,838.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.97 / $390.29 / $619.60
| Professional | | $361.97 | $390.29 | $619.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.68 / $392.68 / $392.68
| Facility | | $392.68 | $392.68 | $392.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.44 / $509.38 / $674.87
| Professional | | $392.44 | $509.38 | $674.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $537.12
| Professional | | $32.34 | $32.34 | $537.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.75 / $457.19 / $619.60
| Facility | | $330.75 | $457.19 | $619.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.31 / $575.07 / $911.08
| Professional | | $400.31 | $575.07 | $911.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.00 / $1,084.00 / $1,401.00
| Facility | | $200.00 | $1,084.00 | $1,401.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.78 / $496.80 / $717.09
| Professional | | $359.78 | $496.80 | $717.09 |