- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $3,548.13 / $10,964.78
| Facility | | $302.00 | $3,548.13 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,096.48 / $2,951.21 / $10,471.29
| Facility | 50 | $1,096.48 | $2,951.21 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $389.05 / $794.33
| Professional | | $229.09 | $389.05 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $169.82 / $426.58 / $758.58
| Professional | 50 | $169.82 | $426.58 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $478.63 / $977.24
| Professional | | $199.53 | $478.63 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $151.36 / $229.09 / $724.44
| Professional | 50 | $151.36 | $229.09 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,786.30 / $10,000.00
| Facility | | $2,238.72 | $4,786.30 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $436.52 / $691.83
| Professional | | $275.42 | $436.52 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $416.87 / $660.69 / $1,023.29
| Professional | 50 | $416.87 | $660.69 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $380.19 / $562.34
| Professional | | $213.80 | $380.19 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $13,182.57 / $17,782.79
| Facility | | $11,481.54 | $13,182.57 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $416.87 / $794.33
| Professional | | $257.04 | $416.87 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $741.31 / $26,302.68
| Facility | | $275.42 | $741.31 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $660.69 / $4,466.84
| Professional | | $338.84 | $660.69 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,818.38 / $5,623.41
| Facility | | $1,819.70 | $2,818.38 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $407.38 / $776.25
| Professional | | $269.15 | $407.38 | $776.25 |