- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.76 / $267.30 / $2,042.00
| Facility | | $77.76 | $267.30 | $2,042.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.48 / $187.41 / $558.00
| Professional | | $71.48 | $187.41 | $558.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $297.12 / $297.12 / $297.12
| Professional | 50 | $297.12 | $297.12 | $297.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.31 / $299.61 / $501.10
| Facility | | $165.31 | $299.61 | $501.10 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $291.27 / $441.94 / $774.90
| Facility | 50 | $291.27 | $441.94 | $774.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.88 / $363.24 / $832.95
| Professional | | $139.88 | $363.24 | $832.95 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $209.84 / $463.95 / $1,249.43
| Professional | 50 | $209.84 | $463.95 | $1,249.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $613.16 / $869.55 / $2,091.82
| Facility | | $613.16 | $869.55 | $2,091.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.61 / $410.17 / $1,031.58
| Professional | | $177.61 | $410.17 | $1,031.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $498.46 / $794.98 / $1,647.10
| Facility | | $498.46 | $794.98 | $1,647.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.69 / $361.65 / $896.25
| Professional | | $155.69 | $361.65 | $896.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.53 / $237.77 / $695.40
| Facility | | $117.53 | $237.77 | $695.40 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $279.85 / $394.72 / $5,111.78
| Facility | 50 | $279.85 | $394.72 | $5,111.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $637.04 / $1,224.64
| Professional | | $295.12 | $637.04 | $1,224.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,063.00 / $1,597.44 / $3,584.00
| Facility | | $1,063.00 | $1,597.44 | $3,584.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.64 / $551.95 / $968.05
| Professional | | $288.64 | $551.95 | $968.05 |