- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,238.72 / $3,801.89
| Facility | | $1,000.00 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $467.74 / $1,288.25
| Professional | | $288.40 | $467.74 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $5,370.32 / $14,454.40
| Facility | | $56.23 | $5,370.32 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $588.84 / $1,548.82
| Professional | | $288.40 | $588.84 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $724.44 / $1,047.13
| Professional | | $549.54 | $724.44 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $794.33 / $1,348.96
| Professional | | $478.63 | $794.33 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $707.95 / $7,079.46
| Facility | | $331.13 | $707.95 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $467.74 / $851.14
| Professional | | $389.05 | $467.74 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $6,918.31 / $15,488.17
| Facility | | $2,570.40 | $6,918.31 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $616.60 / $1,174.90
| Professional | | $346.74 | $616.60 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,148.15
| Professional | | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $5,370.32 / $14,454.40
| Facility | | $56.23 | $5,370.32 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $588.84 / $1,548.82
| Professional | | $288.40 | $588.84 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $7,244.36 / $15,488.17
| Facility | | $2,570.40 | $7,244.36 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $691.83 / $1,513.56
| Professional | | $436.52 | $691.83 | $1,513.56 |