- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.20 / $3,185.73 / $12,036.14
| Facility | | $292.20 | $3,185.73 | $12,036.14 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $11,059.20 / $11,059.20 / $11,059.20
| Facility | 50 | $11,059.20 | $11,059.20 | $11,059.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.93 / $210.76 / $422.83
| Professional | | $62.93 | $210.76 | $422.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $243.41 / $243.41 / $251.87
| Professional | 50 | $243.41 | $243.41 | $251.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.51 / $118.03 / $147.49
| Professional | | $80.51 | $118.03 | $147.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.78 / $448.29 / $841.55
| Facility | | $330.78 | $448.29 | $841.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.90 / $149.77 / $434.33
| Professional | | $65.90 | $149.77 | $434.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.63 / $305.95 / $579.26
| Professional | | $130.63 | $305.95 | $579.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.40 / $365.01 / $817.20
| Facility | | $94.40 | $365.01 | $817.20 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $729.35 / $1,188.18 / $1,659.00
| Facility | 50 | $729.35 | $1,188.18 | $1,659.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.97 / $441.50 / $3,229.91
| Professional | | $254.97 | $441.50 | $3,229.91 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $168.95 / $168.95 / $168.95
| Professional | 50 | $168.95 | $168.95 | $168.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.22 / $427.86 / $579.26
| Facility | | $163.22 | $427.86 | $579.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.74 / $368.00 / $583.20
| Professional | | $147.74 | $368.00 | $583.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $266.95 / $441.50 / $553.72
| Professional | | $266.95 | $441.50 | $553.72 |