- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $10,000.00 / $10,000.00
| Facility | | $10,000.00 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,570.40 / $2,951.21 / $3,548.13
| Professional | | $2,570.40 | $2,951.21 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $208.93 / $11,481.54
| Professional | | $177.83 | $208.93 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $11,748.98 / $19,054.61
| Facility | | $10,000.00 | $11,748.98 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,265.80 / $9,332.54 / $11,481.54
| Professional | | $4,265.80 | $9,332.54 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $15,488.17 / $23,442.29
| Facility | | $4,073.80 | $15,488.17 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21,877.62 / $21,877.62 / $24,547.09
| Professional | | $21,877.62 | $21,877.62 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,365.16 / $12,882.50
| Facility | | $3,311.31 | $4,365.16 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,187.76 / $18,197.01
| Professional | | $1,659.59 | $2,187.76 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $64.57 / $1,819.70
| Professional | | $50.12 | $64.57 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,709.64 / $12,022.64
| Professional | | $5,888.44 | $8,709.64 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $17,378.01 / $17,378.01
| Facility | | $7,413.10 | $17,378.01 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,370.32 / $18,197.01 / $18,197.01
| Professional | | $5,370.32 | $18,197.01 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,762.47 / $7,762.47 / $7,762.47
| Professional | | $7,762.47 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10,715.19 / $19,952.62 / $28,183.83
| Professional | | $10,715.19 | $19,952.62 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $2,951.21 / $4,365.16
| Facility | | $2,951.21 | $2,951.21 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,187.76 / $6,025.60
| Professional | | $1,548.82 | $2,187.76 | $6,025.60 |