- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,344.23 / $3,801.89
| Facility | | $1,000.00 | $2,344.23 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $912.01 / $3,388.44
| Professional | | $371.54 | $912.01 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,344.23 / $9,120.11
| Facility | | $56.23 | $2,344.23 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $1,047.13 / $5,011.87
| Professional | | $407.38 | $1,047.13 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,288.25 / $1,621.81
| Facility | | $676.08 | $1,288.25 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $831.76 / $3,235.94
| Professional | | $380.19 | $831.76 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $645.65 / $8,511.38
| Facility | | $371.54 | $645.65 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,445.44 / $3,090.30
| Professional | | $1,000.00 | $1,445.44 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $3,801.89 / $9,772.37
| Facility | | $524.81 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $1,000.00 / $2,398.83
| Professional | | $436.52 | $1,000.00 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,344.23 / $9,120.11
| Facility | | $56.23 | $2,344.23 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $1,047.13 / $5,011.87
| Professional | | $407.38 | $1,047.13 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $3,981.07 / $9,549.93
| Facility | | $1,318.26 | $3,981.07 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $977.24 / $3,890.45
| Professional | | $426.58 | $977.24 | $3,890.45 |