- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,344.23 / $5,128.61
| Facility | | $1,000.00 | $2,344.23 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $346.74 / $954.99
| Professional | | $208.93 | $346.74 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $5,248.07 / $19,498.45
| Facility | | $524.81 | $5,248.07 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $436.52 / $2,290.87
| Professional | | $218.78 | $436.52 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $426.58 / $575.44
| Professional | | $288.40 | $426.58 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $478.63 / $3,548.13
| Facility | | $100.00 | $478.63 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $407.38 / $758.58
| Professional | | $218.78 | $407.38 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $426.58 / $7,079.46
| Facility | | $204.17 | $426.58 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $295.12 / $630.96
| Professional | | $208.93 | $295.12 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $4,570.88 / $11,220.18
| Facility | | $645.65 | $4,570.88 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $380.19 / $602.56
| Professional | | $213.80 | $380.19 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $1,949.84 / $5,754.40
| Facility | | $1,949.84 | $1,949.84 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $436.52
| Professional | | $323.59 | $323.59 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $5,248.07 / $19,498.45
| Facility | | $524.81 | $5,248.07 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $436.52 / $2,290.87
| Professional | | $223.87 | $436.52 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $4,570.88 / $9,332.54
| Facility | | $1,479.11 | $4,570.88 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $426.58 / $707.95
| Professional | | $229.09 | $426.58 | $707.95 |