- 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
- $177.83 / $1,412.54 / $3,467.37
| Professional | | $177.83 | $1,412.54 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,000.00 / $4,168.69
| Facility | | $56.23 | $1,000.00 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $1,479.11 / $5,248.07
| Professional | | $181.97 | $1,479.11 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $194.98 / $457.09
| Facility | | $194.98 | $194.98 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $1,000.00 / $5,495.41
| Professional | | $234.42 | $1,000.00 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $257.04 / $7,079.46
| Facility | | $158.49 | $257.04 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.15 / $2,089.30 / $3,235.94
| Professional | | $1,148.15 | $2,089.30 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $1,202.26 / $4,466.84
| Professional | | $194.98 | $1,202.26 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,023.29 / $4,168.69
| Facility | | $56.23 | $1,023.29 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $1,479.11 / $5,248.07
| Professional | | $181.97 | $1,479.11 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $2,818.38
| Facility | | $630.96 | $1,862.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $794.33 / $4,570.88
| Professional | | $223.87 | $794.33 | $4,570.88 |