- 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
- $100.00 / $117.49 / $309.03
| Professional | | $100.00 | $117.49 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $1,949.84 / $19,498.45
| Facility | | $257.04 | $1,949.84 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $169.82 / $870.96
| Professional | | $102.33 | $169.82 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $562.34 / $562.34
| Professional | | $457.09 | $562.34 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $501.19 / $1,122.02
| Facility | | $446.68 | $501.19 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $165.96 / $316.23
| Professional | | $104.71 | $165.96 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $380.19 / $7,079.46
| Facility | | $93.33 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $141.25 / $208.93
| Professional | | $97.72 | $141.25 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $169.82 / $263.03
| Professional | | $97.72 | $169.82 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $1,949.84 / $19,498.45
| Facility | | $257.04 | $1,949.84 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $169.82 / $870.96
| Professional | | $102.33 | $169.82 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,691.53 / $8,511.38
| Facility | | $676.08 | $2,691.53 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $162.18 / $288.40
| Professional | | $102.33 | $162.18 | $288.40 |