- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $4,570.88 / $10,964.78
| Facility | | $1,000.00 | $4,570.88 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $2,187.76 / $8,317.64
| Professional | | $169.82 | $2,187.76 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $5,370.32 / $13,803.84
| Facility | | $1,621.81 | $5,370.32 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $190.55
| Professional | | $0.02 | $0.02 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $562.34 / $1,778.28
| Facility | | $34.67 | $562.34 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $245.47 / $1,412.54
| Professional | | $112.20 | $245.47 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $954.99 / $3,388.44
| Facility | | $169.82 | $954.99 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $39.81 / $60.26
| Professional | | $31.62 | $39.81 | $60.26 |