- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,098.00 / $4,182.08 / $12,036.14
| Facility | | $1,098.00 | $4,182.08 | $12,036.14 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $956.50 / $1,163.88 / $2,932.49
| Facility | 50 | $956.50 | $1,163.88 | $2,932.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.10 / $145.96 / $400.90
| Professional | | $47.10 | $145.96 | $400.90 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $162.74 / $183.88 / $990.00
| Professional | 50 | $162.74 | $183.88 | $990.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,232.51 / $1,670.37 / $3,135.72
| Facility | | $1,232.51 | $1,670.37 | $3,135.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.75 / $239.91 / $319.89
| Professional | | $140.75 | $239.91 | $319.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.32 / $364.52 / $476.59
| Professional | | $293.32 | $364.52 | $476.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.50 / $341.24 / $5,194.52
| Facility | | $156.50 | $341.24 | $5,194.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.42 / $364.39 / $2,496.46
| Professional | | $208.42 | $364.39 | $2,496.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.32 / $399.60 / $1,476.40
| Facility | | $293.32 | $399.60 | $1,476.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.00 / $348.62 / $476.59
| Professional | | $269.00 | $348.62 | $476.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $286.50 / $396.70
| Professional | | $5.00 | $286.50 | $396.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.42 / $347.02 / $434.39
| Professional | | $208.42 | $347.02 | $434.39 |