- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,467.37 / $10,000.00
| Facility | | $1,000.00 | $3,467.37 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $1,584.89 / $6,165.95
| Professional | | $316.23 | $1,584.89 | $6,165.95 |
- 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 / $47.86
| Professional | | $0.02 | $0.02 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $117.49 / $10,000.00
| Facility | | $34.67 | $117.49 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.70 / $97.72 / $2,344.23
| Professional | | $53.70 | $97.72 | $2,344.23 |
- 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
- $39.81 / $52.48 / $69.18
| Professional | | $39.81 | $52.48 | $69.18 |