- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,833.01 / $7,479.16
| Facility | | $1,000.00 | $2,833.01 | $7,479.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $2,200.00
| Professional | | $1,000.00 | $1,000.00 | $2,200.00 |
- 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
- $1,914.14 / $1,986.37 / $4,424.97
| Professional | | $1,914.14 | $1,986.37 | $4,424.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.68 / $1,569.07 / $8,669.03
| Facility | | $305.68 | $1,569.07 | $8,669.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.04 / $760.03 / $3,174.31
| Professional | | $523.04 | $760.03 | $3,174.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,836.61 / $2,836.61 / $3,146.80
| Professional | | $2,836.61 | $2,836.61 | $3,146.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,465.36 / $3,465.36 / $3,465.36
| Facility | | $3,465.36 | $3,465.36 | $3,465.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,870.00 / $5,501.76
| Facility | | $1,000.00 | $1,870.00 | $5,501.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $2,464.00
| Professional | | $1,000.00 | $1,000.00 | $2,464.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.48 / $133.69 / $144.88
| Professional | | $126.48 | $133.69 | $144.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.68 / $1,569.07 / $8,669.03
| Facility | | $305.68 | $1,569.07 | $8,669.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $551.88 / $779.32 / $3,305.70
| Professional | | $551.88 | $779.32 | $3,305.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,676.31 / $2,676.31 / $2,943.86
| Facility | | $2,676.31 | $2,676.31 | $2,943.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,851.18 / $2,676.31 / $2,949.19
| Professional | | $1,851.18 | $2,676.31 | $2,949.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,274.80 / $3,077.68 / $5,283.86
| Professional | | $2,274.80 | $3,077.68 | $5,283.86 |