- 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
- $173.78 / $251.19 / $891.25
| Professional | | $173.78 | $251.19 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,479.11 / $4,897.79
| Facility | | $56.23 | $1,479.11 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $426.58 / $3,715.35
| Professional | | $186.21 | $426.58 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $218.78 / $512.86
| Facility | | $218.78 | $218.78 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,096.48 / $1,096.48
| Professional | | $1,071.52 | $1,096.48 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $1,905.46
| Facility | | $676.08 | $741.31 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $316.23 / $1,096.48
| Professional | | $165.96 | $316.23 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $380.19 / $7,079.46
| Facility | | $181.97 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $812.83 / $1,174.90
| Professional | | $380.19 | $812.83 | $1,174.90 |
- 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
- $213.80 / $575.44 / $1,412.54
| Professional | | $213.80 | $575.44 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,479.11 / $4,897.79
| Facility | | $56.23 | $1,479.11 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $426.58 / $3,715.35
| Professional | | $186.21 | $426.58 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,467.37 / $8,511.38
| Facility | | $676.08 | $3,467.37 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $380.19 / $1,412.54
| Professional | | $186.21 | $380.19 | $1,412.54 |