- 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
- $40.74 / $52.48 / $177.83
| Professional | | $40.74 | $52.48 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $4,897.79 / $19,498.45
| Facility | | $117.49 | $4,897.79 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $69.18 / $213.80
| Professional | | $40.74 | $69.18 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $147.91 / $154.88
| Professional | | $79.43 | $147.91 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $97.72 / $218.78
| Professional | | $56.23 | $97.72 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $380.19 / $7,079.46
| Facility | | $56.23 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $51.29 / $75.86
| Professional | | $26.30 | $51.29 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $85.11 / $138.04
| Professional | | $47.86 | $85.11 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $4,365.16 / $4,365.16
| Facility | | $4,365.16 | $4,365.16 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $4,897.79 / $19,498.45
| Facility | | $117.49 | $4,897.79 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $69.18 / $213.80
| Professional | | $40.74 | $69.18 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,772.37
| Facility | | $1,862.09 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $75.86 / $181.97
| Professional | | $52.48 | $75.86 | $181.97 |