- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.20 / $266.77 / $9,022.37
| Facility | | $172.20 | $266.77 | $9,022.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,118.60 / $4,118.60 / $4,118.60
| Facility | 50 | $4,118.60 | $4,118.60 | $4,118.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.59 / $266.77 / $655.16
| Professional | | $180.59 | $266.77 | $655.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.70 / $468.43 / $738.20
| Professional | | $374.70 | $468.43 | $738.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.58 / $386.61 / $660.50
| Facility | | $219.58 | $386.61 | $660.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.66 / $664.45 / $2,210.82
| Professional | | $304.66 | $664.45 | $2,210.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.93 / $580.00 / $1,386.25
| Facility | | $387.93 | $580.00 | $1,386.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.08 / $510.99 / $661.47
| Professional | | $366.08 | $510.99 | $661.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.56 / $373.53 / $500.05
| Professional | | $246.56 | $373.53 | $500.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $2,000.00 / $2,000.00
| Facility | | $2,000.00 | $2,000.00 | $2,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.85 / $446.27 / $694.20
| Professional | | $325.85 | $446.27 | $694.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.00 / $379.30 / $582.79
| Professional | | $310.00 | $379.30 | $582.79 |