- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,089.30 / $3,630.78
| Facility | | $1,000.00 | $2,089.30 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $169.82 / $478.63
| Professional | | $81.28 | $169.82 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $2,884.03 / $19,498.45
| Facility | | $199.53 | $2,884.03 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $194.98 / $1,380.38
| Professional | | $87.10 | $194.98 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $93.33 / $213.80
| Facility | | $93.33 | $93.33 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $218.78 / $467.74
| Professional | | $128.82 | $218.78 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $501.19 / $1,584.89
| Facility | | $446.68 | $501.19 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $199.53 / $436.52
| Professional | | $95.50 | $199.53 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $380.19 / $7,079.46
| Facility | | $83.18 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $263.03 / $389.05
| Professional | | $186.21 | $263.03 | $389.05 |
- 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
- $85.11 / $190.55 / $436.52
| Professional | | $85.11 | $190.55 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,905.46 / $2,691.53
| Facility | | $776.25 | $1,905.46 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $131.83 / $169.82
| Professional | | $69.18 | $131.83 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $2,884.03 / $19,498.45
| Facility | | $199.53 | $2,884.03 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $194.98 / $1,380.38
| Professional | | $87.10 | $194.98 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,162.28 / $8,511.38
| Facility | | $676.08 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $186.21 / $426.58
| Professional | | $89.13 | $186.21 | $426.58 |