- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,548.13 / $9,772.37
| Facility | | $1,000.00 | $3,548.13 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $316.23 / $2,187.76
| Professional | | $85.11 | $316.23 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $5,128.61 / $15,135.61
| Facility | | $1,548.82 | $5,128.61 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $3,981.07
| Professional | | $0.02 | $0.02 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $169.82 / $10,232.93
| Facility | | $34.67 | $169.82 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $645.65 / $1,000.00
| Professional | | $199.53 | $645.65 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $1,071.52 / $3,467.37
| Facility | | $213.80 | $1,071.52 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $50.12 / $147.91
| Professional | | $20.42 | $50.12 | $147.91 |