- 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
- $194.98 / $229.09 / $562.34
| Professional | | $194.98 | $229.09 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,584.89 / $19,498.45
| Facility | | $346.74 | $1,584.89 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $316.23 / $1,513.56
| Professional | | $186.21 | $316.23 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $549.54 / $549.54
| Professional | | $426.58 | $549.54 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $1,096.48
| Facility | | $446.68 | $478.63 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $316.23 / $588.84
| Professional | | $177.83 | $316.23 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $457.09 / $7,079.46
| Facility | | $218.78 | $457.09 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $309.03 / $436.52
| Professional | | $223.87 | $309.03 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,949.84 / $7,079.46
| Facility | | $346.74 | $1,949.84 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $389.05 / $602.56
| Professional | | $218.78 | $389.05 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,584.89 / $19,498.45
| Facility | | $346.74 | $1,584.89 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $316.23 / $1,513.56
| Professional | | $190.55 | $316.23 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,041.74 / $5,623.41
| Facility | | $467.74 | $2,041.74 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $295.12 / $630.96
| Professional | | $190.55 | $295.12 | $630.96 |