- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $6,165.95 / $10,000.00
| Facility | | $831.76 | $6,165.95 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $251.19 / $977.24
| Professional | | $186.21 | $251.19 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $5,248.07 / $57,543.99
| Facility | | $5,011.87 | $5,248.07 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $338.84 / $389.05
| Professional | | $323.59 | $338.84 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $288.40 / $457.09
| Professional | | $218.78 | $288.40 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $389.05 / $436.52
| Professional | | $302.00 | $389.05 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $309.03 / $457.09
| Professional | | $213.80 | $309.03 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $8,709.64 / $14,791.08
| Facility | | $6,456.54 | $8,709.64 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $5,495.41 / $10,000.00
| Facility | | $1,023.29 | $5,495.41 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $295.12 / $812.83
| Professional | | $194.98 | $295.12 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $524.81 / $5,248.07
| Facility | | $371.54 | $524.81 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $398.11 / $512.86
| Professional | | $323.59 | $398.11 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $275.42 / $758.58
| Facility | | $218.78 | $275.42 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $245.47 / $758.58
| Professional | | $117.49 | $245.47 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $10,000.00
| Facility | | $1,348.96 | $3,548.13 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $263.03 / $446.68
| Professional | | $199.53 | $263.03 | $446.68 |