- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,314.90 / $3,384.71 / $9,256.54
| Facility | | $2,314.90 | $3,384.71 | $9,256.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.54 / $2,451.10 / $2,904.44
| Professional | | $471.54 | $2,451.10 | $2,904.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.55 / $3,131.50 / $3,249.68
| Professional | | $500.55 | $3,131.50 | $3,249.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.31 / $601.66 / $7,546.28
| Facility | | $273.31 | $601.66 | $7,546.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.99 / $321.51 / $506.63
| Professional | | $200.99 | $321.51 | $506.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.10 / $413.87 / $821.89
| Professional | | $321.10 | $413.87 | $821.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,452.69 / $3,507.35 / $9,459.03
| Facility | | $2,452.69 | $3,507.35 | $9,459.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.65 / $2,452.69 / $2,907.54
| Professional | | $500.65 | $2,452.69 | $2,907.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.50 / $344.50 / $463.40
| Professional | | $344.50 | $344.50 | $463.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $260.92 / $584.15 / $7,570.74
| Facility | | $260.92 | $584.15 | $7,570.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.99 / $318.98 / $510.79
| Professional | | $200.99 | $318.98 | $510.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $277.50 / $285.02 / $285.02
| Facility | | $277.50 | $285.02 | $285.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.25 / $277.50 / $286.27
| Professional | | $226.25 | $277.50 | $286.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $266.79 / $1,672.75 / $3,249.68
| Professional | | $266.79 | $1,672.75 | $3,249.68 |