- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.61 / $988.00 / $2,932.04
| Facility | | $115.61 | $988.00 | $2,932.04 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $741.00 / $741.00 / $1,482.00
| Facility | 50 | $741.00 | $741.00 | $1,482.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.55 / $211.74 / $401.19
| Professional | | $75.55 | $211.74 | $401.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.52 / $627.00 / $2,733.00
| Facility | | $179.52 | $627.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.07 / $489.43 / $2,809.18
| Professional | | $101.07 | $489.43 | $2,809.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.01 / $118.03 / $213.36
| Facility | | $93.01 | $118.03 | $213.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.74 / $242.18 / $755.12
| Professional | | $103.74 | $242.18 | $755.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $169.60 / $6,679.00
| Facility | | $83.43 | $169.60 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.43 / $456.77 / $687.46
| Professional | | $349.43 | $456.77 | $687.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.93 / $272.92 / $832.84
| Professional | | $114.93 | $272.92 | $832.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.76 / $91.76 / $91.76
| Professional | | $91.76 | $91.76 | $91.76 |
- 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
- $309.77 / $748.96 / $2,809.18
| Professional | | $309.77 | $748.96 | $2,809.18 |
- 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
- $301.70 / $478.78 / $895.47
| Professional | | $301.70 | $478.78 | $895.47 |