- 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
- $426.58 / $501.19 / $1,513.56
| Professional | | $426.58 | $501.19 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,677.35 / $19,498.45
| Facility | | $1,071.52 | $4,677.35 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $691.83 / $3,388.44
| Professional | | $354.81 | $691.83 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $851.14 / $1,621.81
| Professional | | $512.86 | $851.14 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $870.96 / $7,079.46
| Facility | | $380.19 | $870.96 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $478.63 / $707.95
| Professional | | $245.47 | $478.63 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $812.83 / $1,288.25
| Professional | | $446.68 | $812.83 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $4,677.35 / $19,498.45
| Facility | | $1,096.48 | $4,677.35 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $691.83 / $3,388.44
| Professional | | $354.81 | $691.83 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $10,715.19
| Facility | | $1,584.89 | $3,630.78 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $741.31 / $1,698.24
| Professional | | $501.19 | $741.31 | $1,698.24 |