- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.30 / $1,418.00 / $3,363.00
| Facility | | $245.30 | $1,418.00 | $3,363.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $138.25 / $306.82 / $306.82
| Facility | 50 | $138.25 | $306.82 | $306.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.46 / $82.73 / $199.51
| Professional | | $52.46 | $82.73 | $199.51 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $117.69 / $311.79 / $510.00
| Professional | 50 | $117.69 | $311.79 | $510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.76 / $536.38 / $2,713.00
| Facility | | $91.76 | $536.38 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.50 / $129.15 / $574.26
| Professional | | $62.50 | $129.15 | $574.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.73 / $84.46 / $150.78
| Facility | | $65.73 | $84.46 | $150.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.74 / $120.51 / $182.02
| Professional | | $83.74 | $120.51 | $182.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.25 / $121.92 / $215.73
| Professional | | $72.25 | $121.92 | $215.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.24 / $189.76 / $6,679.00
| Facility | | $60.24 | $189.76 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.35 / $115.50 / $159.32
| Professional | | $95.35 | $115.50 | $159.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.54 / $154.56 / $236.74
| Professional | | $73.54 | $154.56 | $236.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.69 / $441.88 / $1,108.51
| Facility | | $209.69 | $441.88 | $1,108.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.08 / $137.01 / $226.04
| Professional | | $89.08 | $137.01 | $226.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.26 / $169.92 / $632.14
| Professional | | $85.26 | $169.92 | $632.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $417.12 / $1,115.64 / $2,733.00
| Facility | | $417.12 | $1,115.64 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.91 / $123.52 / $321.49
| Professional | | $82.91 | $123.52 | $321.49 |