- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.77 / $988.00 / $2,747.00
| Facility | | $123.77 | $988.00 | $2,747.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.89 / $127.22 / $264.20
| Professional | | $46.89 | $127.22 | $264.20 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $731.58 / $731.58 / $731.58
| Professional | 50 | $731.58 | $731.58 | $731.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.43 / $627.00 / $2,733.00
| Facility | | $109.43 | $627.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.67 / $258.49 / $1,845.61
| Professional | | $61.67 | $258.49 | $1,845.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.28 / $71.42 / $129.11
| Facility | | $56.28 | $71.42 | $129.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.87 / $94.09 / $348.00
| Professional | | $19.87 | $94.09 | $348.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.98 / $180.03 / $412.05
| Professional | | $65.98 | $180.03 | $412.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $160.46 / $6,679.00
| Facility | | $53.00 | $160.46 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.27 / $238.63 / $397.92
| Professional | | $183.27 | $238.63 | $397.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.70 / $165.10 / $440.97
| Professional | | $69.70 | $165.10 | $440.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.73 / $233.53 / $742.92
| Facility | | $115.73 | $233.53 | $742.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.03 / $151.91 / $395.25
| Professional | | $77.03 | $151.91 | $395.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $953.00 / $2,796.00
| Facility | | $308.00 | $953.00 | $2,796.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.26 / $406.01 / $1,845.61
| Professional | | $174.26 | $406.01 | $1,845.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.99 / $284.39 / $495.76
| Professional | | $156.99 | $284.39 | $495.76 |