- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.21 / $91.40 / $2,042.00
| Facility | | $51.21 | $91.40 | $2,042.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.89 / $82.67 / $304.38
| Professional | | $48.89 | $82.67 | $304.38 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $109.71 / $109.71 / $336.93
| Professional | 50 | $109.71 | $109.71 | $336.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.70 / $1,179.08 / $2,457.60
| Facility | | $424.70 | $1,179.08 | $2,457.60 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,576.86 / $2,392.44 / $4,194.93
| Facility | 50 | $1,576.86 | $2,392.44 | $4,194.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.94 / $176.38 / $310.00
| Professional | | $98.94 | $176.38 | $310.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $144.71 / $263.89 / $462.56
| Professional | 50 | $144.71 | $263.89 | $462.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.37 / $317.72 / $764.32
| Facility | | $214.37 | $317.72 | $764.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.75 / $197.24 / $369.36
| Professional | | $108.75 | $197.24 | $369.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.13 / $290.47 / $601.83
| Facility | | $182.13 | $290.47 | $601.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.67 / $185.00 / $346.33
| Professional | | $107.67 | $185.00 | $346.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.40 / $138.94 / $1,005.30
| Facility | | $69.40 | $138.94 | $1,005.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.28 / $203.09 / $481.59
| Professional | | $95.28 | $203.09 | $481.59 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $264.38 / $429.97 / $965.93
| Professional | 50 | $264.38 | $429.97 | $965.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,187.00 / $2,872.00 / $4,241.00
| Facility | | $1,187.00 | $2,872.00 | $4,241.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.22 / $151.34 / $316.16
| Professional | | $89.22 | $151.34 | $316.16 |